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Mli^uHiene c^H^xUe^ute 



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ME 55 • NUMBER 1 

MONTREAL 



Highlight for 
ANUARY 1959 



Strabismus 
Dr. Howard Reed 



Ready for 1959 




rAMAHIAM Klll» < t C > ACCOriATIO 



"For the utmost in fashion and quality, ifs time to wear White Sister." 

THREE-WAY BEAUTY 




THE CIIIDIM IllRSE 



INDEX 



Volume 55 




L'lPIRMIEIlE ailDIEME 



OWNED AND PUBLISHED BY THE 
CANADIAN NURSES' ASSOCIATION 



PROPRIETE ET PUBLICATION DE 
L'ASSOCIATION DES INFIRMIERES CANADIENNES 



THE CANADIAN NURSE 



JOURNAL BOARD 

\'0TiNG Members : 

Chairman — Mrs. Isobel MacLeod 
Sister Mary Felicitas 
Rae Chittick 
Helen M. Carpenter 
Suzanne Giroux 
Alice Girard (ex officio) 
Ethel Gordon 
Katherine MacLaggan 

Non-Voting Members : 

M. Pearl Stiver 
Secretary — Margaret E. Kerr 

EDITORIAL ADVISERS 

Alberta Irene M. Robertson, Nurse Supervisor, Imperial Oil Limited, 

Edmonton. 

British Columbia Marion E. Macdonell, Health Unit No. 5, 2610 Victoria 

Drive, Vancouver 12. 

Manitoba Sheila L Nixon, 25 Langside St., Apt. 24, Winnipeg. 

New Brunswick Shirley Y. Alcoe, 180 Charlotte St., Fredericton. 

Newjoundland Isabel Sutton, 66A Mullock Street, St. John's 

Nova Scotia Mrs. Hope Mack, P.O. Box 76, Hantsport. 

Ontario Jean Watt, R.N..'\.0., 33 Price Street, Toronto. 

I'rince Edward Island Sister Mary David, Director of Nursing Service, Charlottctown 

Hospital, Charlottctown. 

Quebec Genevieve Lamarre, School of Nursing, Hopital de I'Enfant- 

Jesus, Quebec. 

Sister Mary Assumpta, Obstetrical Supervisor, St. Mary's 

Hospital. Montreal. 

Saskatchewan \'ictoria Antonini, Executive Secretary, S.R.N. .A,., 2066 Retal- 

lack Street, Regina. 



THE CANADIAN NURSE 
L'INFIRMIERE CANADIENNE 

Index to Volume 55 
1959 

The material in this Index is arranged under subjects, authors, and titles. Titles are 
given in full with the author's name. 

L'arrangement des articles dans cet index se comprend d'apres le sujet, I'auteur et le 
titre. Le titre se lit au long, de meme que le nom de I'auteur. 

The following abbreviations appear in this Index : 

Les abreviations suivantes sont utilisees dans I'index : 

A. I.e. — Association des Infirmieres Canadiennes 
CNA — Canadian Nurses' Association 
(ed.) — editorial 
I.C.N. — Internationa] Council of Nurses 
I.L.O. — International Labor Organization 
O.I.T. — Organisation Internationale du Travail 
(por.) — photograph 
(rev.) — book review 
UNESCO — -United Nations Educational, Social and Cultural Organization 
U.S. — United States 

Note: The italicized numbers in this Index indicate pages in L'Infirmiere Canadienne. 

Avis: Les nombres en italique dans cet index indiquent les pages de I'lnfirmiere 
Canadienne. 

Page numbers fot \'olume 55 — The Canadian Nurse, are : 

January pp. 1-88 July pp. 585- 672 

February pp. 89-184 August pp. 673- 768 

March pp. 185-288 September pp. 769- 872 

April pp. 289-392 October pp. 873- 968 

May pp. 393-488 November pp. 969-1072 

June pp. 489-584 December pp. 1073-1 168 

Les numeros des pages du volume 55 de I'lnfirmiere Canadienne sont : 

juin pp. 1-64 septembre pp. 193-256 

juillet : pp. 65-128 octobre pp. 257-312 

aoiit pp. 129-192 novembre pp. 313-376 

decembre pp. 377-440 

A Adviser to schools of nursing (Schuma- 
cher), 332 
Affections renales : 

About the staphylococcus (Murray), 787 Le rein artificiel (Rackham). i(55 

Accident prevention: Les soins infirmiers (Harris, Dossetor), 

Boracic acid — the wolf in sheep's cloth- 19 

ing (Halliday), 1093 Transplantation renale chez les jumelles 

Death from plastic film (Jeffrey), 1096 identiques (MacKinnon), 17 

Get down to brass tacks — prevent home Afffxtions du sang: 

accidents (Robertson), 1097 .Anemie hemolytique familiale (Sagesse), 

The problem of poisons (Dean), 1091 112 

Table of antidotes. 1095 Erythroblastose foetale (Rutledge), 365 

AciDK b<jrit|ue — ou le loup sous la peau .Aikix. Ruth Catherine & por., 37 

d'une brebis. r (Halliday), i92 Air pollution: 

AcTU.M.iTK et perspective (Tremblay), 434 Garbage in the sky, 260 

Administration de nursing: .Ai.bert.a : 

L'evaluation du personnel (Boshouwers) , The adviser to schools of nursing (Schu- 

45 macher), 332 

Interdependance du cout quotidien du .\nnual meeting in (Van Dusen), 1046 

nursing et de sa qualite (Decary), 30 Assemblee annuelle en, (Van Dusen), 343 

AnvANCED preparation in nursing (Rlieault), Certified Nursing Aide Association 

904 (Quirk). 254 

—1— 



A dream comes true (Van Dusen), (ed.), 
103 

News notes, 66, 164, 262, 362, 463 

Provincial roundup, 352 
Alberta Certified Nursing Aide Association 

(Quirk), 254 
Alcoe, Shirley Yvonne & por., 529, 37 
Alexander, Edythe L. 

Care of the patient in surgery including 
technique (rev.). 436 
Allemang, Margaret 

An analysis of the experiences of eight 
cardiac patients during a period of hos- 
pitalization in a general hospital, 702, 151 

Corrected information, 876, 260 
Analyse des experiences personnelles de 

huit cardiaques pendant un sejour dans un 

hopital general ( Allemang), i5i, 2d0 
Analyse de la visite a domicile en sante 

maternelle (Doyon), 148 
Analyse des visites aux nourrissons (Car- 
penter), 229 
Analysis of the experiences of eight cardiac 

patients during a period of hospitalization 

in a general hospital (Allemang), 702, 876 
Analysis of home visits to newborn infants 

made by the public health nurses in the 

East York-Leaside Health Unit, Ontario 

(Carpenter), 809 
Anderson, Jean (rev.), 652, 189 
Anderson, Kay (rev.), 652, 189 
Anemie hemolytique familiale (Sagesse), 112 
Anne-Marie 

L'aube de la joie (rev.), 250 
Annuaire officiel, 64, 129, 192, 256, 376 
Annual meetings : 

Alberta (Van Dusen), 1046 

British Columbia (Wright), 846 

Canadian Tuberculosis Association (Mc- 
Killop), 1144 

Saskatchewan (Antonini), 842 
Anomalies congenitales : 

Le spina-bifida et I'hydrocephalie (Fer- 
ret), 369 
Another reason for hope (Lamarre), 1026 
Anshell, Mrs. N. (rev.), 1051, 375 
Anthony, Catherine Parker 

Textbook of anatomy and physiology 
(rev.), 1050, 375 
Antibiotics in cosmetics, 1052 
Antidotes : 

Table of, 1095 
Antidotes essentiels, 394 
Antoniades, Katherine (Goos, Sellers) 

Pre-eclamptic toxemia, 1005 

Toxemic pre-eclamptique, 349 
Antonini, Mabel Victoria & por., 531, 39 

Annual meeting in Saskatchewan, 842 

Assemblee annuelle en Saskatchewan, 245 
Application for participation in retirement 

plan, 1117 
Appreciation de textes, 1', 63, 125, 189, 250, 

309, 375, 436 
Aquila, Mother, 1133, 426 
Architecture des hopitaux : 

Un aspect moderne du soin des malades 
(Flanagan), 163 
Armstrong, Inez L. (Browder) 

The nursing care of children (rev.), 748, 
252 
Article writing : 

Here's how to do it, 840 

Writer's cramp (Poland), 523 
Artificial kidney (Rackham), 716 



Aspect communautaire et le nursing, 1' (Du 

Gas, Blackwood), 298 
Aspect moderne du soin des malades, un 

(Flanagan), 163 
AssEMBLEES anuuclles : 

en Alberta (Van Dusen), 343 

en Colombie-Britannique (Wright), 247 

en Nouveau-Brunswick (Cote), 248 

en Saskatchewan (Antonini), 245 
Association Canadienne de la Tuberculose, 

438 
Association des Infirmieres Canadiennes, 1' : 

Changement d'adresse, 227 

Le comite de recherche de, 408 

Conference des membres du personnel des 
associations nationales et provinciales, 
161 

Demande de participation au plan de re- 
traite, 411 

Fonds de construction, 248 

Son histoire 1954-59, 354 

Liste des publications, 58 

Nouveau siege social, 407 

Plan de retraite, 162, 410 
AssuMPTA, Sister Mary & por., 531, 39 
Attriblition exclusive, une, 29 
AuBE de la joie, I' (Anne-Marie), (rev.), 

250 
Autre raison d'esperer, une (Lamarre), 364 
Auxiliaires en nursing: 

Des cours d'entrainement pour la certifi- 
cation de I'infirmier (Dick, Carruthers), 
184 
Avery, Hazel (Miller) 

Gynecology and gynecologic nursing (rev.), 
1150 
Award winners — Macmillan Co. of Canada, 

Ltd., 1958, 362 



B 



Bacteriologie : 

L'infection staphylococcique (Southern- 
Holt), 210 
Les maladies staphylococciques chez les 

nourrissons (Robinson), 215 
Le staphylocoque (Murray), 205 
Bacteriology : 

About the staphylococcus (Murray), 787 
The control of staphylococcal infections 

(Rose), 795 
Prevention and control of cross-infection 
in the nursery of the normal newborn 
(Z wicker), 797 
Prevention of staphylococcal infections in 

the operating room (MacNeill), 799 
The problem of staphylococci in the oper- 
ating room and central supply room 
(Smith), 801 
Staphylococcal diseases in infancy (Rob- 
inson), 794 
Staphylococcal infection (Southern-Holt), 
791 
Barbeau, Huguette & por.. 1035, 362 
Barber, Edith M. (Cooper, Mitchell, Ryn- 
bergen) 

Nutrition in health and disease (rev.), 
746, 251 
Barcelo, Soeur Juliette (rev.), 125 
Basic teaching in surgical nursing (Dus- 

seault), 891 
Bean. Nancy (rev.), 461 
Beatrice, Sister & por., 1134, 427 
Beaudin, Norman R., 495 



—2— 



The CNA retirement plan becomes a re- 
ality, 329 

Comment vous pouvez aider, 59 

How you can help, 524 
Belcher. Helen C. (Tschudin, Nedelsky) 

Evaluation in basic nursing education 
(rev.), 256 
Benesch, Ann 

Cardiac catheterization — specific nursing 
care, 696 
Bentley, Reginald S. 

The male potential, 344 
Bergeron, Annonciade (Martineau) & por., 

133 ^ 
Besoin d'entreprendre des recherches en 

nursing, le (Fidler). 41 
Better utilization of the students' time in 

the clinical field (Felicitas), 321 
Between ourselves, 4. 92, 188, 292. 396, 492, 

588, 676, 772, 876, 972, 1076 
Biennial convention, 1960: 

Application form, 1011 

CNA European tour, 548 

Convention accommodation, 1012 

Post-convention study tour, 713 

Preliminary program, 1115 

Program takes shape, 442, 446 

Revised itinerary, 1960 European tour, 1018 
BiENVENUE a rinfirniiere Canadicnne (Gi- 

rard), 13 
Bird. Joseph G. (Musser) 

Modern pharniacologv and tlierapeufics 
(rev.). 256 
Black's medical dictionary (Thomson), 

(rev.). 840, J09 
Blackwood, Barbara (Du Gas) 

L'aspect communautaire et le nursing, 298 

Teaching community aspects of nursing, 
932 
Blake, Florence G. (Jeans, Wright) 

Essentials of pediatrics (rev.), 560, 63 
Blessures a la tete : 

Effet mental d'une, (Gibson), 420 
Blood conditions : 

Erythroblastosis fetalis (Rutledge), 1022 

Familial hemolytic anemia (Sagesse), 641 
BoBEY. Grace (rev.), 1148, 436 
Bone conditions : 

Multiple myeloma (Kuczmak), 623 
Book reviews, 256, 358, 461, 558, 652 746, 

840, 1049, 1146 
BoRAcic acid — the wolf in sheep's cloth- 
ing (Halliday). 1093 

BOSHOUWERS, H. 

The evaluation of personnel, 532, 45 
Bourns, Beulah V. 

Sawdust beds, 162 
BoYER. Annie (Merrylees), 639, 104 
British Columbia : 

Annual meeting in, (Wright), 846 

Building on our likenesses (Rossiter), 
(ed.), 407 

News notes, 68, 166, 264, 364, 463 

Provincial roundup, 352 
Browder, Jane J. (Armstrong) 

The nursing care of children (rev.), 748, 
252 
Brown, Amy Frances 

Research in nursing (rev.), 256 
Bru lures : 

Le probleme des, (Christie), 288 

I-e programme de rehabilitation (Pakal- 
nins), 293 

Dans la salle (Lepot), 289 



.\ la salle d'operation (Szmidl ), 292 

Les soins infirmiers a donner aux lesions 
thermiques (\'irginia), 417 

Soins infirmiers individualises (MacLeod), 
288 
Bryant, Floranna Dorothv & por., 1129, 

423 
Building on our likenesses (Rossiter), 

(ed.), 407 
Burns : 

One person's nursing care (MacLeod), 912 

In the operating room (Szmidt). 918 

The problem of, (Christie), 912 

The rehabilitation program (Pakalnins), 
922 

On the ward (Lepot), 914 
Burton, Genevieve 

Personal, impersonal and interpersonal re- 
lations (rev.), 653, 190 
Butler, Dorothy 

The rehabilitation of Mrs. Moritz, 215 
Buts professionnels : 

Lettre a ma niece (Zalloni), 181 



Cairney, John (Cairney) 

First studies in anatomv and physiology 
(rev.), 1148 
Cairney, John 

Surgery for students of nursing (rev.), 
462 
Calasanctius, Sister Mary (rev.), 560, 127 
Campion, F. Lillian 

Rapport d'un comite special de I'O.LT., 56 

Report of I.L.O. ad hoc committee, 52 
Canadian Nurses' Association: 

.Association activities, 1954-59, 1010 

Building fund, 244 

Exchange of privileges program. 632 

. . . house, 444, 448 

Institute — staffs of national and provin- 
cial nursing associations, 712 

New location, 805, 1113 

Publications list, 556 

Research committee personnel, 53. 540, 1116 

Retirement plan, 244, 248, 329. 444, 524, 
713, 1116 
Canadian Tuberculosis Association annual 

meeting (McKillop), 1144 
Cancer : 

du sein droit (Johnston), 175 

Infiltrative duct carcinoma of right breas-f 
(Johnston), 738 

Malignant stomach ulcer (Parrent), 834 

Ulcere gastrique malin (Parrent), 17S 
Cancer du sein droit (Johnston), 175 
Cardiac arrest (Cruickshank), 305 
Cardiac catheterization (Gumming), 691 
Cardiac catheterization — general nursing 

care (Macmillan), 695 
Cardiac catheterization — specific nursing 

care (Benesch), 696 
Cardiac surgery : 

Cardiac arrest (Cruickshank), 305 

Cardiac catheterization (Gumming), 691 

Cardiac catheterization — general nursing 
care (Macmillan), 695 

Cardiac catheterization — specific nursing 
care (Benesch), 696 

Congenital heart surgery (Mildenberger), 
307 

Nursing care in a mitral commissurotomy 
(Snidal), 421 



—3- 



Preparation for nursing in, (Parent), 902 
Care of ihc patient in surgery including 

technique (Alexander), (rev.), 436 
Carmel. Sister Mary 

Health work on Okinawa, 40 
Carpenter, Helen M. & per., 807, 226 

Analyse des visites aux nourrissons, 229 

An analysis of home visits to newborn 
infants made by the public health nurses 
in the East York-Leaside Health Unit, 
Ontario. 809 
Carruthers. Peter R. (Dick) 

A certified orderly training program, 72>2 

Des cours d'entrainement pour la certifi- 
cation de I'infirmier, 184 
Cas d'hepatite infectieuse, un (Trenchard), 

61 
Catheterisme cardiaque (Macmillan), 146 
Catheterisme du coeur, le (Cumming), 

141 
Cerebellar artery thrombosis (Jutras), 424 
Certified orderly training program (Dick, 

Carruthers), 732 
Cetose diabetique, la (Dahl), 202 
Charter, Christine E. & por., n28, 422 
Chest conditions : 

Nursing care of the thoracic surgical pa- 
tient (Hinson, Oleksyn, Dafoe), 218 
Child welfare: 

Supportive maternal and child care (Cun- 
ningham), 990 
Chirurgie cardiaque : 

Catheterisme cardiaque (Macmillan), 146 

Le catheterisme du coeur (Cumming), 141 

Nursing chirurgical en cardiologie (Pa- 
rent), 2/9 

Traitement de Tinsufifisance aortique a 
I'aide d'une valve en plastique (Creigh- 
ton, Hufnagel, Thorn, Presley), 21 
Christie, Anna 

The problem of burns, 912 

Probleme des brulures, le. 288 
Christmas reverie (Giroux), (ed.), 1089 
CiXQ annees de progres (Story), (ed.), 72) 
CiRcn.ATORV conditions : 

Cerebellar artery thrombosis (Jutras), 424 

Coronarv artery thrombosis (Trenholm), 
428 

Hereditarv factor in high blood pressure, 
554 

Strokes, 50 
Civil defence : 

Content for nursing education programs 
in the U.S., 444 
Clair-Obscur of the picture (Cote), (ed.), 

689 
Clair-O'-scur du tableau, le (Cote), (ed.), 

139 
Cleft lips and palates (Hill), 439 
Clixical teaching : 

Better utilization of the students' time 
in the clinical field (Felicitas), 321 

in surgical nursing (Ouimet), 893 
Clinical teaching in surgical nursing (Oui- 
met), 893 
Cna retirement plan becomes a realitv 

(Beaudin), 329 
Colombie-Britannique: (Voir aussi Bri- 
tish Columbia) 

Assemblee annuelle en, (Wright), 247 
Color in your home, 241 
CoLViN, Isabel T. & por., 425 
CoLviN, Isabel T. (Jones, Mitchell) 

Planning a demonstration night, 938 



Une seance de demonstrations, 371 
Comment vous pouvez aider (Beaudin), 59 
Common cold, 905 
Communicable diseases: 

The venereal disease clinic (Schroeter), 42 
Communication : 

L'infinniere educatrice et conseillere (No- 
tebaert). 314 
Community aspects of nursing: 

Teaching, in the basic curriculum (Du 
Gas, Blackwood), 932 
Congenital abnormalities : 

Spina bifida and hydrocephalus (Per ret), 

nil 

Congenital heart surgerv (Mildenberger), 

307 
Congres biennal, 1960: 

Application, 357 

Itineraire revise. 359 

Le logement pour le, 358 

L'organisation de ce voyage d'etudes, 162 

Programme preliminaire, 409 

Voyage en Europe, 55 
CoNSEiL international des infirmieres : 

bureau des directeurs, 286 
Control of staphylococcal infections (Rose), 

795 
Coombs, Ralph (rev.), 436 
Cooper, Lenna F. (Barber, Mitchell, Ryn- 

bergen) 

Nutrition in health and disease (rev.), 
746, 251 
Coronary artery thrombosis (Trenholm), 

428 
Cote, Gabrielle Dolores & por., 526, 34 

Assemblee annuelle en Nouveau-Bruns- 
wick. 248 

Le clair-obscur du tableau (ed.), 139 

The clair-obscur of the picture (ed.), 689 
Cours approfondis en obstetrique destines 

aux finissantes (Mann), 347 
Cours d'entrainement pour la certification 

de I'infirmier. des (Dick, Carruthers), 184 
Crampe des ecrivains, la (Poland), 32 
Cranna, Elva M. (rev.), 462 
Crawford. Elva (rev.), 1150 
Crawford. Myrtle E. (Heieren) 

Rehabilitation in a teaching program, 201 
Creasor. Alberta & por., 909, 285 
Creighton. Helen (Hufnagel, Thorn, Pres- 

Entraide au-dela de la frontiere. 21 
Croken, Mary 

Don't bend an elbow. 744 

Pour ne pas lever le coude, 101 
Cruickshank, Lionel F. G. 

Cardiac arrest, 305 
Cryderman, Ethel & por., 36 
Cumming, G. R. 

Cardiac catheterization, 691 

Catheterisme du coeur. 141 
Communicable diseases: 

The venereal disease clinic (Schroeter), 42 
Cunningham. Norah E. 

Soins de soutien de la mere et I'enfant, 
327 

Supportive maternal and child care, 990 
Cutler, Ryllys Mae & por., 233 



Dafoe, C. A. (Hinson, Oleksyn) 

Nursing care of the thoracic surgical 
patient, 218 



Dahl, Doris Haave 

La cetose diabetique, 302 

Diabetic ketosis, 1038 
Dallaire, Gertrude & por., 233 
Dans la salle (Lepot), 289 
Dans le bon vieux temps, 44, 97, 162, 209, 

283, 338, 438 
David, Sister Mary & por., 530, 38 
Dean, John 

The problem of poisons. 1091 

Le probleme des poisons, 389 
Death from plastic film (Jeffrey), 1096 
Decary, Soeur Mance 

Une fructueuse pratique, 228 

Interdependance du cout quotidien du 
nursing et de sa qualite, 30 

The relationship between the quality of 
nursing care and its cost, 521 
Defense civile : 

Enseignement de la, parmi les infirmieres, 

446 

Les soins infirmiers a donner aux lesions 
thermiques (Virginia), 417 
Delisle, Claude 

Traitement de la pneumonie, 412 
Dermatose : 

Pemphigus vulgaris (Sobie), 114 
Desjardins, Mariette 

Le nursing chirurgical pediatrique. 272 

Pediatric surgical nursing, 896 
Developpements professionnels : 

Cinq annees de progres (Story), (ed.), 
73 

Une nouvelle realisation (Wheeler), (ed.), 
11 

Les trois autres R — ces inconnus (Hick- 
man), 24 
Diabete: 

La cetose diabetique (Dahl), 302 
Diabetes : 

Diabetic ketosis (Dahl). 1038 
Diabetic ketosis (Dahl), 1038 
Diagnostic procedures : 

Cardiac catheterization (Cumming). 691 

Cardiac catheterization — general nursing 
care (Macmillan), 695 

Cardiac catheterization — specific nursing 
care (Benesch), 6% 

Gastrointestinal intubation (Grobin), 106 
Dick, Dorothy (Carruthers) 

A certified orderly training program, 732 

Des cours d'entrainement pour la certifi- 
cation de I'infirmier, 184 
Dignity of service (Kerr), (ed.). 303 
Disinfection : 

Skin antisepsis (Price). 222 
DivERTicui.E oesophagien (Myers). 91 
Dix commandements de la future maman. 

les (Thibault). 33 
Dolora. Sister Mary (rev.). 360 
Don't bend an elbow (Croken), 744 
DoRLANu's ffocket )iicdical dictionary (rev.), 

461 
DossETOR. John (Harris) 

Renal transplant — nursing care. 508 

Les soins infirmiers. 19 
DoYON. Mary Alice Rita & por.. 1132. 424 

Une analyse de la visite a domicile en 
sante materneile, 148 

Home visiting and maternal healtli. 700 

Les responsabilites de I'infirmiere hygie- 
niste, 95 

The responsibilities of the public health 
nurse, 635 



Dream comes true (Van Dusen), (ed.), 103 
Du Gas, Beverly W. (Blackwood) 

L'aspect communautaire et le nursing, 298 
Teaching communitv aspects of nursing, 
932 
Dunn, Rosalie. 234 
Duodenal ulcer (Lemieux), 109 
DuPLAiN, Patricia 

L'organisation et la conduite d'une as- 
semblee, 143 
DussEAULT, Rita 

Basic teaching in surgical nursing, 891 
Enseignement de base en nursing chirur- 
gical, 270 



Ear conditions : 
Hearing loss, 27 
Measurement of sound, 38 
Middle ear surgery, 62 
Eaton, Amaryllis 

Pneumonie lobaire, 416 
Right lobar pneumonia, 1108 
Editorials : 

Building on our likenesses (Rossiter), 407 

A Christmas reverie (Giroux), 1089 

The clair-obscur of the picture (Cote), 

689 
The dignity of service (Kerr), 303 
A dream comes true (\'an Dusen). 103 
Five years of progress ( Story ) , 599 
Great expectations (Poole), 889 
The meaning of faith (Girard), 13 
-K new milestone (Wheeler). 503 
Nursing in New Brunswick (Smith), 199 
Our golden jubilee (Gerard). 783 
\'isiting our neighbors (MacGregor), 985 
Editoriaux 

Cinq annees de progres (Story), 73 
Le clair-obscur du tableau ( Cote ) . 139 
De grandes attentes ( Poole ) , 265 
Notre jubile d'or (Gerard), 201 
Une nouvelle realisation (Wheeler), 11 
Reflexions pour la vigile de Noel (Gi- 
roux), 387 
En visite chez nos voisins (MacGregor), 
321 
Education de nursing : 

L'aspect communautaire et le nursing (Du 

Gas, Blackwood), 298 
Une autre raison d'esperer (Lamarre), 

364 
Cours approfondis en obstetrique destines 

aux finissantes (Mann), 347 
Enseignement de base en nursing chirur- 
gical (Dusseault), 270 
Formation superieure en nursing chirur- 
gical (Rheault), 281 ^^ 
Instruction clinique a I'etudiante en nurs- 
ing chirurgical (Ouimet),267 
Lettre a ma niece (Zalloni), 181 
Le nursing au rythme des progres mo- 

dernes (Gagnon), 323 
Le nursing chirurgical pediatrique ( Des- 
jardins), 272 
Le perfectionnement par I'exercice ( Tar- 

dif), 276 
Le role de I'infirmiere-sage-femme en 

Grande-Bretagne ( Mills ) . 334 
Une seance de demonstrations (Colvin, 

Jones. Mitchell). 371 
Les trois autres R — ces inconnus ( Hick- 
man ) , 24 
Education for nursing lcodcrshif> ( Lam- 



bertson), (rev.), 558, 127 
Educational programs : 

Advanced preparation in nursing 
(Rheault), 904 

Basic teaching in surgical nursing (Dus- 
seault), 891 

Clinical teaching in surgical nursing (Oui- 
met). 893 

Pediatric surgical nursing ( Desjardins), 
896 

Perfection through practice (Tardif), 899 

Planning a demonstration night (Colvin, 
Jones. Mitchell), 938 
Effets de la solitude a I'admission aux 

hopitaux. des, 311 
Effet mental d'une blessure a la tete (Gib- 
son), 420 
Egax. Margaret M. (rev.), 256 
Eldridge, Carole 

Peptic ulcer, 114 
Elle a hcauconp aime (Mitchell), (rev.), 

250 
Ellis, Kathleen W. (rev.), 558, 127 
Emergexcv care : 

Cardiac arrest (Cruickshank) , 305 

Rabies, 558 

Table of antidotes, 1095 
Emotional problems of the worker (Ham- 
ilton), 409 
Emotionally disturbed patients (Ward), 

1144 
Employment opportunities, 72, 169, 268, 

i72, 467, 566, 656, 750, 848, 946, 1055, 1153 
Enseignement de base en nursing chirur- 

gical ( Dusseault), ^Z*? 
Entraide au-dela de la frontiere (Creigh- 

ton, Hufnagel, Thorn, Presley), 21 
Entre nous, 4. 68. 132, 196. 260, 314, 380 
Erythroblastose foetale (Rutledge), 365 
Erythroblastosis fetalis (Rutledge), 1022 
Esophageal diverticulum (Myers), 616 
Esophageal speech: 

Teaching, (Stockley), 310 
EsQuissES du mois, les, 34, 102, 173, 225, 

284, 362. 422 
Essentials of pediatrics (Jeans, Wright, 

Blake), (rev.), 560, 63 
European tour, 548, 1018 
Evaluation : , 

The adviser to schools of nursing (Schu- 
macher ) , ?i32 
Evaluation ;"■; basic nursing education 
(Tschudin. Belcher, Nedelsky), (rev.), 

256 
Evaluation du personnel, 1" (Boshouwers), 

45 
Evaluation of personnel (Boshouwers), 532 
Eye conditions : 

Squint or strabismus (Reed), 16 
Eye. car. nose and throat manual for nurses 
(Parkinson), (rev.), 840, 5i^ 



Faith and loyalty (Riley). 39 

Famu.ial hemolytic anemia (Sagesse), 641 

F.^MiLY guide to teenage health (Wilkes), 

(rev.),' 747, 309 
Family handbook of home nursing and 

medical care (Rossman, Schwartz), (rev.), 

652. 189 
Felicitas. Sister Mary 

Better utilization of the students' time in 
the clinical field, 321 



Fidler, Nettie D. 

Le besoin d'entreprendre des recherches 

en nursing, 41 
The need for research in nursing, 224 
Films : 

Hospital sepsis : a communicable disease, 
1126 
Finger nails ; 

A new treatment for brittle, (Hallidav). 
348 
First aid : 

Table of antidotes, 1095 
To use or not to use (Lindsey), 1142 
First studies in anatomy and physiology 

(Cairney, Cairney), (rev.), 1148 
Five years of progress (Story), (ed.), 599 
Flanagan, Eileen C. 
Un aspect moderne du soin des malades, 

163 
A modern version of patient care, 726 
FoNCTiONs professionnelles : 

Cinq annees de progres (Storv), (ed.), 
73 
Food fads, 460 

Food habits of new Canadians, 945 
Foreign countries : 
Japan : 

Mission to, (Naudett), 128 
Okinawa 

Health work on (Carmel), 40 
Formation superieure en nursing chirurgi- 

cal (Rheauh), 281 
Fowler, Dorothy & por., 133 
Francis, Carl C. 

Introduction to human anatomy (rev.), 
1148, 436 
P'raude civile : 

Sous de fausses couleurs (MacGregor), 
118 
From witchcraft to zvorld health (Leff, 

Leff), (rev.), 1051, 375 
Fructueuse pratique, une (Decary), 228 
Fundamentals in nursing care (Montag, 

Swenson), (rev.), 1146, 436 
Furlong, Evelyn L., (rev.), 749, 252 



Gagnon, Jacqueline (por.) 323 

Le nursing au rythme des progres mo- 
dernes, 323 

In step with modern progress, 987 
Garbage in the sky, 260 
Gass, Florence, (rev.), 562, 126 
Gastrointestinal conditions : 

Duodenal ulcer (Lemieux), 109 

Esophageal diverticulum (Myers). 616 

intubation (Grobin), 106 

Malignant stomach ulcer (Parrent), 834 

Peptic ulcer (Eldridge), 114 

Pyloric stenosis (Pavan), 120 
Gastrointestinal intubation (Grobin), 106 
Gavin, Ann F. 

The registrar, 164 
Geiger, Elsbeth & por.. 714, i7.? 
Gerard. Sister Catherine, & por. 232, 772 

783, 196. (por.), 201 

Notre jubile d'or (ed.), 201 

Our golden jubilee (ed.), 783 
Geriatrics : 

Mental health hazards in later life (Stev- 
enson), 414 
Get down to brass tacks — prevent home 

accidents (Robertson). 1097 



—6— 



GiBsox, John 

Flffel mental d'une blessure a la tete, 420 

Involutional melancholia, 1028 

The manic-depressive psychosis, 928 

La meiancolie involutive, 367 

Mental effects of head injury, 1118 

La psychose maniaco-depressive, 296 

Schizophrenia, 830 

La schizophrenie, 242 
Gilchrist, Joan Muriel & por., 1130 
GiRARD, Alice (por.), 13 

Bienvenue a i'lnfirmiere Canadienne, 13 

The meaning of faith (ed.), 13 

Welcome to I'lufinuierc Canadienne, 505 
GiROUx, Suzanne, 1076, & por. 1089, (rev.), 

250.380. (por.) 387 

A Christmas reverie (ed.), 1089 

Reflexions pour la vigile de Noel (ed.), 
387 
Goi.DBLOOM. Alton 

Snmll patients (rev.), 1049, 376 
(jOos, Katherine (Sellers, Antoniades) 

Pre-eclaniptic toxemia, 1005 

Toxemie pre-eclamptique, 349 
Gragg, Shirley Hawke (McClain) 

Scientific principles in nursing (rev.), 
560, 128 
Graham, Eleanor Scott & por., 807, 225 
Grandes attentes, de, (Poole), (ed.), '265 
Gravdox. William R. 

A new orthopedic brace, 350 
Great expectations (Poole), (ed.), 889 
Greetixgs from the ICN president (Ohl- 

son), 138 
Grexier, Edouard 

Voix secretes, 435 
Grieve, Doris M. & por., 232 
Grobix^ \V. 

Gastrointestinal intubation, 106 
Gynecologv and gynecologic nursina (Mil- 
ler, Avery), (rev"), 1150 



H 



Habitudes alimentaires des Xeo-Canadiens, 

356 
Hallas. Charles H. 

The nursinci of mental defectix'cs (rev.), 

358 
Hai.i.idav, Claire 

L'acide borique — ou le loup sous la peau 
d'une brebis, 392 

Boracic acid — the wolf in sheep's cloth- 
ing, 1093 

A new treatment for brittle nails, 348 
Hamii.tox, Kenneth A. 

Emotional problems of the worker, 409 
Handbook of cardioloqx for nurses (Modell, 

Schwartz), (rev.), 562, 126 
Harmox. Francis L. (Sheehy) 

Psychology for nurses (rev.), 747, 252 
Harris. Shirley (Dossetor) 

Renal transplant — nursing care, 508 

Les soins infirmiers, 19 
Head injuries : 

Mental effects of, (Gibson), 1118 
Health work on Okinawa (Carmel), 40 
Heart conditions : 

An analysis of the experiences of eight 
cardiac patients during a period of hos- 
pitalization (Allemang), 702 

Cardiac arrest (Cruickshank), 305 

Cardiac catheterization (Gumming), 691 

Cardiac catheterization — general nursing 



care (Macmillan) , 695 

Cardiac catheterization — specific nursing 
care (Benesch), 696 

Congenital heart surgery (Mildenberger), 
307 

Myocardial infarction (McDermid), 610 

Nursing care in mitral commissurotomy 
(Snidal), 421 
Heierex, Eleanor L. (Crawford) 

Rehabilitation in a teaching program, 201 
Hejlsted, Bente & por., 637, 102 
Hexrichon, Marthe 

Le maintien de I'enfant d'age scolaire, 240 

Posture and the school age child, 826 
Here's how to do it, 840 
HiBBARD. Marjory, 327 
HiBBERT. Dorothy Maud & por., 132 
Hickman, W. Harry 

The other three R's, 516 

Les trois autres R — ces inconnus, 24 
Highway deaths, 1054 
Hill. Dorothy J. 

Cleft lips and palates, 439 
HiNsoN, J. W. ( Oleksyn, Dafoe) 

Nursing care of the thoracic surgical 
patient, 218 
Histoire: 

L'association des Infirmieres Canadiennes, 
1954-59, 354 

Dans le bon vieux temps 44, 97, 162, 209, 
283. 338, 438 

Notre jubile d'or (Gerard), (ed. ), 201 

\'oici le Canada (Young), 75 

La voix du passe, 426 
Historical : 

Canadian Nurses' Association, 1954-59, 
1010 

In the good old days 20, 131, 204, 359, 416, 
512, 640, 713, 806, 944. 1036, 1150 

Medicine man (Wyatt), 46 

Our golden jubilee (Gerard), (ed.), 783 

A silver anniversary (University of To- 
ronto), 48 

This is Canada (Young), 601 

Voice of the past, 1133 
Home care : 

and maternal health (Doyon), 700 

The rehabilitation of Mrs. Moritz (But- 
ler), 215 

The story of Johnny (Miller), 214 
Home visiting and maternal health (Doyon), 

700 
Hospital architecture : 

A modern version of patient care (Flana- 
gan), 726 
Hospital housekeeping (Wickens), HOC 
Hospital maintenance : 

housekeeping (Wickens), 1100 

La tenue d'un hopital (Wickens), 400 
Hospital personnel : 

The evaluation of, (Boshouwers). 532 

How, feel about nursing care (Schweis- 
heimer), 456 
Hospital sepsis : a communicable disease 

(film), 1126 
How hospital personnel feel about nursing 

care (Schweisheimer), 456 
How you can help (Beaudin), 524 
Hudson, Marie E. & por., 807, 225 
Huffman, \^erna & por., 1032 
Hifnagel, Charles A. (Creighton, Thorn, 

Presley) 

Entraide au-dela de la frontiere, 21 
Hurler's disease (Philippe), 1122 



—7— 



Hydrocephalie : 

Le spina-bifida et 1', (Perret), 269 
Hydrocephalus : 

Spina bifida and, (Perret), 1111 
Hygiene publique : 

Une analyse de la visite a domicile en 

sante maternelle (Doyon), 148 
Analyse des visites aux nourrissons (Car- 
penter) , 229 
Le maintien de I'enfant d'age scolaire 

(Henrichon), 240 
Les responsabilites de I'infirmiere-hygie- 

niste (Doyon), 95 
Le role de rinfirmiere-sage-femme en 

Grande-Bretagne (Mills), 334 
Soins de soutien de la mere et I'enfant 
(Cunningham), 327 



I 



Ideal retirement plan for nurses, 1116 

Ile du Prince-Edouard (Voir aussi Prince 

Edward Island) 
In memoriam, 29, 134, 238 ^27. 450, 544, 
639. 715, 778, 942, 1009, 1140, 57, 124, 174, 
228, 301, 361, 430 
In the good old days, 20, 131. 204, 359, 416, 

512, 640, 713, 806, 944, 1036, 1150 
In the operating room (burns), (Szmidt), 

918 
In step with modern progress (Gagnon), 

987 
Infarctus du myocarde (McDermid), 85 
Infection in hospitals : 

About the staphylococcus (Murray), 787 
The control of staphylococcal infections 

(Rose), 795 
Prevention and control of cross-infection 
in the nursery of the normal newborn 
(Z wicker), 797 
Prevention of staphylococcal infections in 

the operating room (MacNeill), 799 
The problem of staphylococci in the ope- 
rating room and central supply room 
(Smith). 801 
Staphylococcal diseases in infancy (Robin- 
son), 794 
Staphylococcal infection (Southern-Holt), 
791 
Infection staphylococcique, 1' ( Southern - 

Uo\t),210 
Infections hospitalieres : 
L'infection staphylococcique ( Southern- 
Holt), 210 
Les maladies staphylococciques chez les 

nourrissons (Robinson), 215 
Prevention des infections staphylococci- 
ques a la salle d'operation (MacNeill), 
219 
Prevention et controle de l'infection mixte 
a la pouponniere du nouveau-ne 
(Z wicker), 217 
Le probleme des staphylocoques a la salle 
d'operation et au service central (Smith), 
221 
Problemes et controles des infections a 

staphylocoques (Rose), 213 
Le staphylocoque (Murray), 205 
Infectious hepatitis (Trenchard), 552 
Infiltrative duct carcinoma of right breast 

(Johnston). 738 
L'inf'irmiere educatrice et conseillere (Note- 

baert), 314 
Instruction clinique a I'etudiante en nur- 



sing chirurgical (Ouimet), 267 
Interdependance du cout quotidien du nur- 
sing et de sa qualite (Decary), 30 
International Council of Nurses : 

Board of Directors meeting, Helsinki, 
Finland, 442 

Bureau de direction, 446 

Greetings from the . . . president (Ohl- 

son), 138 

International essay competition, 62, 442 

Report of Board meeting, 906 

Study of psychological problems in gen- 
eral hospitals, 540, 52 
International essay competition (I.C.N.), 

62 
International Labor Organization, ad hoc 

committee, 52. 56 
Introduction to human anatoinx (Francis), 

(rev.). 1148, 436 
Involutional melancholia (Gibson), 1028 
Is nursing at the service of patients (Rey- 
nolds), 513 
Ives, Janet Cranston, 909, 285 



James, Ethel (rev.), 653, 190 
James, Leroy 

Relaxation, 325 
Jamieson, F. Louise & por., 908, 284 
Jeans, Philip C. (Wright, Blake) 

Essentials of pediatrics (rev.), 560, 63 
Jeffrey, Fred W. 

Death from plastic film, 1096 

Pellicule de i>olythene : danger de mort, 395 
Johnson, Doreen (rev.), 360 
Johnson, Ida Evelyn & por.. 714, 173 
Johnston, Dorothy C. 

Cancer du sein droit. 175 

Infiltrative duct carcinoma of right breast, 
738 
Jones, Gertrude 

A research project in a premature nursery, 
432 
Jones, S. (Colvin. Mitchell) 

Planning a demonstration night, 938 

Une seance de demonstrations, 371 
JuTRAS, Ellen 

Cerebellar artery thrombosis, 424 



Kemp, Edith (rev.), 1148, 437 

Kennedy, Fanny Ann & por., 1032, 363 

Kerr, Margaret E. & por., 526, 34 

The dignity of service (ed.), 303 
Kidney conditions : 

The artificial kidney (Rackham), 716 

Renal transplant — nursing care (Harris, 
Dossetor), 508 

Renal transplantation in identical twins 
(MacKinnon), 506 
KiLLiAN, Hans 

Sotis le regard de Dieu (rev.), 251 
Kraines, Samuel Henry 

Mental depressions and their treatment 
(rev.), 461 
KuczMAK, Annie 

Multiple myeloma, 623 



Lady Stanley Institute for trained nurses 
(MacBeth), (rev.), 1151 



— R— 



Lamarke, Genevieve &• por., 531, 39 

Another reason for hope, 1026 

Une autre raison d'esperer, 364 
Lambertsen, Eleanor C. 

Education for nursing leadership (rev.), 
558, 127 
Landreth, Catherine 

The psvchology of earlv childhood (rev.), 
360 ' 
Lane, Isabel & por., 234 
Laryngectomy : 

Teaching esophageal speech (Stocklev), 
310 
Leckie, Irene & por., 1128, 422 
Lefebvre, Sister Denise (rev.), 654, ]25 
Lefk, S. (Leff) 
Leff, Vera (Leff) 

From lintchcraft to icorld health (rev.), 
1051, 375 
Lemieux, Helen 

Duodenal ulcer, 109 
Lepot, Doreen 

Dans la salle, 289 

On the ward, 914 
Letter to my niece (Zalloni), 728 
Lettre a ma niece (Zalloni), 181 
LiFGREX, Edna E. (Shafer, Sawyer, Mc- 

Cluskey ) 

Medical-surgical nursing (rev.), 652, 189 
LiGUE \ationale du Nursing: 

Le nursing au rythme des progres mo- 
dernes (Gagnon), 323 

En visite chez nos voisines (MacGregor), 
(ed.), 321 
LiNDSEY, Douglas 

S'en servir, oui ou non, 186 

To use or not to use, 1142 
Liste des publications (I'A.I.C.), 58 
Liver conditions : 

Infectious hepatitis (Trenchard), 552 
LoRETTo, Sister Mary (rev.), 747, 252 
Lung conditions : 

Pneumonia (de la Mare), 1105 

Right lobar pneumonia (Eaton), 1108 



M 



MacArthur, Christine 

We teach — do our patients learn, 205 
MacBeth, Madge 

Lady Stanley Institute for Trained Xurses, 

1151 
MacDonell, Marion Edith & por., 528, 36 
M.acGregor, Jean Elizabeth & por., 526, 34 

No boundary lines, 644 

Sans bornes et sans fins. 120 

Sous de fausses couleurs, 118 

Under false colors, 633 

En visite chez nos voisines (ed.), 321 

Visiting our neighbors (ed.), 985 
MacIsaac, Rita (por.), 354 

Un tribut, 354 

Tribute to, 1010 
Mack, Hope (Munro) & por., 529, por., 

808, 37, 226 
MacKinnon, Kenneth J. 

Renal transplantation in identical twins, 
506 

Transplantation renale chez des jumelles 
identiques, 17 
MacLfx)d. Ann Isobel 

One per.son's nursing care, 912 

Soins infirmiers individuahses, 288 
Macmii.i.an award winners, 362 



Macmillan. Xancy D. 

Cardiac catheterization — general nursing 

care, 695 
Catheterisme cardiaque, 146 
MacNeill, Hazel L. 

Prevention des infections staphylococci- 

ques a la salle d'operation, 219 
Prevention of staphylococcal infections in 
the operating room, 799 
Madeleine of Jesus, Sister & por., 1034, 362 
Maintien de I'enfant d'age scolaire, le (Hen- 

richon), 240 
Malades aux troubles emotifs (Ward), 244 
Maladie de foie : 

Un cas d'hepatite infectieuse (Trenchard), 
61 
Maladie de Hurler (Philippe), 431 
Maladies de coeur : 
Analyse des experiences personnelles de 
huit cardiaques pendant un sejour dans 
un hopital general (Allemang), 151 
Catheterisme cardiaque (Macmillan), 146 
Le catheterisme du coeur (Gumming), 141 
Infarctus du myocarde (McDermid), 85 
Traitement de I'insutifisance aortique a 
I'aide d'une valve en plastique (Creigh- 
ton, Hufnagel, Thorn, Presley). 21 
Maladies de I'estomac : 

Diverticule oesophagien (Myers), 91 
Ulcere gastrique malin (Parrent), 178 
Maladies mental es : 

EfFet mental d'une blessure a la tete 

(Gibson), 420 
La melancolie involutive (Gibson), 367 
La psychose maniaco-depressive (Gibson), 

296 
La schizophrenic (Gibson), 242 
Maladies pulmonaires : 

La pneumonie (de la Mare), 413 
Pneumonic lobaire (Eaton), 416 
Traitement de la pneumonie (Delisle), 
412 
Maladies staphylococciques chez Ics nour- 

rissons, les (Robinson), 215 
Male nurses : 

The male potential (Bentley), 344 
The past has a future (Wedgery), 135 
Male potential (Bentley), 344 
Malignant stomach ulcer (Parrent), 834 
MANic-depressive psychosis (Gibson), 928 
Manitoba : 
News notes, 68, 166, 264, 463 
Provincial roundup, 352 
Mann, Helena C. E. 

Cours approfondis en obstetrique destines 

aux finissantes, 347 
Planning senior experience in obstetrics, 
1003 
Manuel de nutrition et de dietotherapie 

(St-Jean-Eudes), (rev.), 125 
Mare, de la, Eleanore 
Pneumonia. 1 105 
La pneumonie, 413 
Marney, Florence 

Nursing at Springhill. 156, 160 
Martel, Yvonne, 38 

Master plan of rotation (Street), 30, 139 
Matheson, Margaret Mary & por., 714, 

172 
McClain, M. Esther (Gragg) 
Scientific principles in nursing (rev.). 560, 
128 

McCluskey, .Audrey M. (Shafer, Sawyer, 
Lifgren) 



—9— 



Medical-surgical nursing (rev.), 652, 189 
McCoLL, Alargaret Lorena 

The rehabilitation team, 210 
McCrimmox, Jean 

Nursing in psychiatric divisions of gen- 
eral hospitals, 250 
McDermid, Sister Rita 
Infarctus du myocarde, 85 
Myocardial infarction, 610 
McDowell, Edith M. (rev.), 256 
McHale, Helen (rev.), 1146, 436 
McKiLLOP, Madge 

Canadian Tuberculosis Association annual 
meeting, 1144, 438 
McPhedran, Margaret G. & por., 1128, 

422 
Meaning of faith (Girard), (ed.), 13 
Measurement of sound, 38 
MEDicAL-surgical nursing (Shafer, Sawyer, 

McCluskey, Lifgren), (rev.), 652, 189 
Medication : 

A new, setup (Morley), 312 
Medecine man ( Wyatt), 46 
Melancolie involutive, la (Gibson), 367 
Memorial to Gretta MacKay Ross, 234 
Mental deficiency : 

Mongolism (Nelson), 452 
Mental dc/^rcssions and their treatment 

(Kraines), (rev.), 461 
Mental eflfects of head injury (Gibson), 

1118 
Mental health : 

Emotional problems of the worker (Ham- 
ilton), 409 
hazards in later life (Stevenson), 414 
The psychiatrist and the child (Statten), 

620 
Safety signs for (Stevenson), 907 
Mental health hazards in later life (Stev- 
enson), 414 
Meres celibataires : 

Pourquoi les juger (Ste. Mechtilde), 339 
Mesukes preventives : 

L'acide borique — ou le loup sous la peau 

d'une brebis (Halliday), 392 
Liste d'antidotes essentiels, 394 
Pellicule de polythene : danger de mort 

(Jefifrey), 395 
Le probleme des poisons (Dean), 398 
Soyons prudentes — prevenons les acci- 
dents au foyer (Robertson), 396 
Methodes d'enseignement : 

L'aspect communautaire et le nursing (Du 

Gas. Blackwood), 298 
de base en nursing chirurgical (Dus- 

seault), 270 
L'infirmiere educatrice et conseillere (No- 

tebaert). 314 
Instruction clinique a I'etudiante en nurs- 
ing chirurgical (Ouimet), 267 
Le nursing chirurgical pediatrique (Des- 

jardins), 272 
Le perfectionnement par I'exercice (Tar- 
dif), 276 
Metropolitan Demonstration School of 
Nursing : 

Present activities of alumnae members, 
540. 53 
MiCROBioiX)GV and epideniiologv (Thomp- 
son), (rev.), 560, 127 

MiLDENRERGER, A. T. 

Congenital heart surgery, 307 
Miller, Lorraine F. 

The story of Johnny, 214 



Miller, Xorman R. (Avery) 

Gynccologv and gvnecologic nursing 
(rev.), ilSO 
Mills, Alice C. 

Le role de I'infirmiere-sage-femme en 
Grande-Bretagne, 334 

The role of the nurse-midwife in Great 
Britain, 995 
Miner, Eleanor Louise & por., 1032 
Misrepresentation : 

Under false colors (MacGregor), 633 
Mission to Japan (Naudett), 128 
Mitchell, D. (Colvin, Jones) 

Planning a demonstration night, 938 

Une seance de demonstrations, 371 
AIitchell, Soeur E. 

Elle a beaueoup aime (rev.), 250 
Mitchell, Helen S. (Cooper. Barber, Ryn- 

bergen ) 

Nutrition in health and disease (rev.), 746, 
251 
MoDELL, Walter (Schwartz) 

Handbook of cardiology for nurses (rev.), 
562, 126 
Modern pharmacology and therapeutics 

(Musser, Bird), (rev.), 256 
Modern version of patient care (Flanagan), 

726 
Mongolism (Nelson), 452 
Montag, Mildred L. (Swenson) 

Fundamentals in nursing care (rev.), 1146 
436 
MooRE, Thomas Verner (Stevens) 

Principles of ethics (rev.), 654, 125 
MoRLEY, P. 

A new medication setup, 312 
Mokoney, James 

Surgery for nurses (rev.), 462 
Mortalites de la route, les, 374 
Morton, Sister Victoria & por., 639, 104 
Multiple myeloma (Kuczmak), 623 
Munro, Jessica 

The nurse's life, 356 
Murray, E. G. D. 

About the staphylococcus, 787 

Le staphylocoque, 205 
Musser, Ruth D. (Bird) 

Modern pharmacology and therapeutics 
(rev.), 256 
Myers, Bernice 

Diverticule oesophagien, 9/ 

Esophageal diverticulum, 616 
Myocardial infarction (McDermid), 610 



N 



National League for Nursing : 

Biennial meeting May 11-15, 1959 (Mac- 
Gregor), (ed.), 985 

In step with modern progress (Gagnon). 
987 
Nature de la recherche, la (Uprichard). 

105 
Nature of research (Uprichard). 318 
Naudett, Hazel F. 

Mission to Japan, 128 
Nedelsky, Leo (Tschudin. Belcher) 

Evaluation in basic nursing education 
(rev.), 256 
Need for research in nursing (Fidler), 224 
Nelson, Winnifred 

Mongolism, 452 
New Brunswick : 

News notes, 166, 265, 364 



—10— 



Nursing in. (Smith), 199 

Provincial roundup, 352 
New medication setup (Morley), 312 
New orthopedic brace (Graydon), 350 
New products, 6. 94, 190, 294. 398, 494, 590, 

678, 774, 878. 974, 1078 
New treatment for brittle nails (Halliday), 

348 
Newkocxdlaxd : 

Five years of progress (Story), (ed.), 599 

Provincial roundup, 354 
News notes, 66, 164, 262, 362, 463 
Niblett, Muriel E. & por., 1132, 425 
Nixon, Sheila Margaret & por., 529, 36 
No boundary lines (MacGregor), 644 

NOTEKAERT, YvCtte 

L'infirmiere educatrice et conseillere, 314 
Notre jubile d'or (Gerard), (ed), 201 
Nouveau-Brl'nswick : (Voir aussi New 

Brunswick) 

Assemblee annuelle au, (Cote), 248 
NorvEAUX produits, 6, 69, 134, 187, 199, 261, 

315, 382 (\"oir "New Products" pour liste 

alphabetique ) 
NouvEi.LE-EcossE : (Voir aussi Nova Sco- 
tia) 

Notre jubile d'or (Gerard), (ed.), 201 
Nou\ELLE realisation, une (Wheeler), (ed.), 

11 
Nova Scotia : 

News notes. 68. 265. 364, 464 

Our golden jubilee (Gerard), (ed.), 783 

Provincial roundup, 354 
Nurse's life (as mirrored in Shakespeare), 

(Munro), 356 
Nursing across the nation, 52, 154, 242, 338, 

442, 540, 631, 712, 805, 906, 1010, 1113 
Nursing administration : 

The evaluation of personnel (Boshou- 
wers), 532 

In step with modern progress (Gagnon), 
988 

The relationsliip between the quality of 
nursing care and its cost (Decary), 521 
Nursing assistant : 

Alberta Certified Nursing Aide Associa- 
tion (Quirk), 254 

A certified orderly training program 
(Dick, Carruthers"). 732 
Nursing au rythme des progres modernes, 

le (Gagnon), 323 
Nursing care : 

The artificial kidney (Rackham), 716 

Cardiac catheterization — general (Mac- 
mil Ian). 695 

Cardiac catheterization — specific (Be- 
nesch ) , 696 

Cerebellar artery thrombosis (Jutras), 424 

Cleft lips and palates (Hill). 439 

Congenital heart surgerv (Mildenberger), 
307 

The control of staphvlococcal infections 
(Rose). 795 

Coronarv artery thrombosis (Trenholm), 
428 

Diabetic ketosis (Dahl). 1038 

Don't bend an elbow (Croken), 744 

Duodenal ulcer (Lemieux), 109 

Erythroblastosis fetalis (Rutledge). 1022 

Esophageal diverticulum (Myers), 616 

Familial hemolytic anemia (Sagesse), 641 

in hemorrhoidectomy (Rowland), 123 

How hospital personnel feel about, 
(Schweisheimer ), 456 



Hurler's disease (Philippe) 1122 
Infectious hepatitis (Trenchard), 552 
Infiltrative duct carcinoma of right breast, 

(Johnston), 738 
Malignant stomach ulcer (Parrent), 834 
in a mitral commissurotomy (Snidal), 421 
A modern version of patient, (Flanagan), 

726 
Mongolism (Nelson), 452 
Multiple myeloma (Kuczmak), 623 
Myocardial infarction (McDermid), 610 
One person's, (MacLeod), 912 
The pediatric nurse and play therapy 

(Pinkerton), 28 
Pemphigus vulgaris (Sobie), 627 
Peptic ulcer (Eldridge), 114 
Pre-eclamptic toxemia (Goos, Sellers, An- 

toniades), 1005 
Preparation for, in cardiac surgery (Pa- 
rent), 902 
Pyloric stenosis (Pavan), 120 
The rehabilitation of Mrs. Moritz (But- 
ler), 215 . 
The rehabilitation team (McColl), 210 
Renal transplant, (Harris, Dossetor), 508 
Right lobar pneumonia (Eaton), 1108 
Sawdust beds (Bourns), 162 
Spina bifida and hydrocephalus (Perret), 

nil 

The story of Johnny (Miller), 214 
Supportive maternal and child care (Cun- 
ningham ) , 990 
of the thoracic surgical patient (Hinson, 

Oleksyn, Dafoe), 218 
On the ward (Lepot), 914 
We teach — do our patients learn (Mac- 
Arthur), 205 
Nursing care of children (Armstrong, 

Browder), (rev.), 748, 252 
Nursing care in hemorrhoidectomv (Row- 
land). 123 
Nursing care in a mitral commissurotomy 

(Snidal), 421 
Nursing care of the thoracic surgical patient 

(Hinson, Oleksyn, Dafoe), 218 
Nursing chirurgical en cardiologie (Pa- 
rent), 279 
Nursing chirurgical pediatrique, le (Des- 

jardins), 272 
Nursing education : 

Advanced preparation in nursing 

(Rheault), 904 
The adviser to schools of nursing (Schu- 
macher), 332 
Another reason for hope (Lamarre), 1026 
Basic teaching in surgical nursing (Dus- 

seault), 891 
Better utilization of the students' time in 

the clinical field (Felicitas), 321 
Clinical teaching in surgical nursing (Oui- 

met). 893 
Financial assistance for, brief on, 631 
The master plan of rotation (Street), 30, 

139 
The other three R's (Hickman), 516 
Pediatric surgical nursing (Desjardins), 

896 
Perfection through practice (Tardif), 899 
Planning a demonstration night (Colvin, 

Jones, Mitchell), 938 
Planning senior experience in obstetrics 

(Mann). 1003 
Rehabilitation in a teaching program 
(Crawford, Heieren), 201 



—11— 



The role of the nurse-midwife in Great 

Britain (Mills), 995 
In step with modern progress (Gagnon), 

987 
Teaching community aspects of nursing 
(Du Gas, Blackwood), 932 
Nursing est-il au service du malade, le 

(Reynolds), 13 
Nursing in New Brunswick (Smith), (ed.), 

199 
Nursing in psychiatric divisions of general 

hospitals (McCrimmon), 250 
Nursing oj mental defectives (Hallas), 

(rev.), 358 
Nt'RsiNG profiles, 36, 132, 232, 326, 526, 637, 

714, 807, 908, 1032, 1128 
Nursing service : 

An analysis of the experiences of eight 
cardiac patients during a period of hos- 
pitalization (Allemang), 702 
Better utilization of the students' time in 

the clinical field (Felicitas), 321 
A certified orderly training program 

(Dick, Carruthers), 7 32 
The dignity of, (Kerr), (ed. ), 303 
Une fructueuse pratique (Decary), 228 
Great expectations (Poole), (ed.). 889 
Is nursing at the service of patients (Rey- 
nolds), 513 
The master plan of rotation (Street), 30, 

139 
Prevention and control of cross-infection 
in the nursery of the normal newborn 
(Zwicker), 797 
Prevention of staphylococcal infections in 
the operating room (MacNeill), 799 
The problem of staphylococci in the oper- 
ating room and central supply room 
(Smith), 801 
The relationship between the quality of 
nursing care and its cost (Decary), 521 
Nursing Sisters' Association, 122 
Nursing at Springhill (Marney). 156 
Nursing a travers le pays, 56, 158, 246, 341, 

446, 52, 109, 161, 227, 286, 354, 406 
Nutrition : 
Food fads, 460 

Food habits of new Canadians, 945 
Habitudes aliinentaires des Neo-Canadiens, 
356 
Nutrition in health and disease (Cooper, 
Barber, Mitchell, Rynbergen), (rev.), 746, 
251 
Nutrition manual for nurses (Shackleton), 

(rev.), 360 
Nutting, M. Adelaide, 226 



Obstetrics : 

Erythroblastosis fetalis (Rutledge), 1022 

Home visiting and maternal health (Doy- 
on). 700 

Planning senior experience in, (Mann), 
1003 

Pre-eclamptic toxemia (Goos, Sellers, An- 
toniades), 1005 

The role of the nurse-midwife in Great 
Britain (Mills), 995 

Supportive maternal and child care (Cun- 
ningham), 990 
Obstf.trique: 

Une analyse de la visite a domicile en 
sante maternelle (Doyon), 148 



Cours approfondis en destines aux finis- 
santes ( Mann), 347 

Erythroblastose foetale (Rutledge). 365 

Le role de I'infirmiere-sage-femme en 
Grande-Bretagne (Mills), 334 

Soins de soutien de la mere et I'enfant 
( Cunningham ) , 327 

Toxemic pre-eclamptique (Goos, Sellers, 
.•\ntoniades), 349 
Occup.\Ti0NAL nursing : 

Emotional nroblems of the worker (Ham- 
ilton). 409 
Official directory. 286, 370, 673, 770 
Offres d'emplois, 63, 128, 191, 255, 312, 

373, 439 
Ohlson, Agnes (por.), 29 

Une attribution exclusive, 29 

Greetings from the ICN president, 138 

Unique award, 558 
Oi.EKsvN, E. E. (Hinson, Dafoe), 

Nursing care of the thoracic surgical 
patient. 218 
Ox the ward (burns), Lepot, 914 
One person's nursing care (MacLeod), 912 
Ontario: 

Appointments, transfers, resignations, 64, 
262 

News notes, 70. 167, 266, 364, 465 

Provincial roundup, 354 
Ophthaemoi.ogicai. conditions : 

Squint or strabismus (Reed), 16 
Organisation et la conduite d'une assem- 

blee, r (Duplain), 143 
Orthopedics : 

A new, brace (Graydon), 350 
Other three R's (Hickman). 516 
Otolaryngology : 

Hearing loss, 27 

Measurement of sound, 38 

Middle ear surgery, 62 
OuiMET, Jacqueline & por.. 638, 103 

Clinical teaching in surgical nursing. 893 

Instruction clinique a I'etudiante en nurs- 
ing chirurgical (Ouimet),26" 
Our golden jubilee (Gerard), (ed.), 783 
Outpatient department : 

The venereal disease clinic (Schroeter), 42 



Pakalnins, Irmgard 

Le programme de rehabilitation, 293 

The rehabilitation program. 922 
Paraphrase of Paul's thirteenth chapter of 

First Corinthians for nurses (Waters), 

746 
Parent, Adrienne 

Nursing chirurgical en cardiologie, 279 

Preparation for nursing in cardiac sur- 
gery, 902 
Parkinson, Roy H. 

Eve, car, nose and throat manual for 
'nurses (rev.), 840. 310 
Parrent. Maureen 

Malignant stomach ulcer. 834 

Ulcere gastrique malin, 178 
Parry, Dora & por.. 37 
Past has a future (Wedgery), 135 
Paul, Evelyn Mary & por., 326 
Pavan. Adeline 

Pyloric stenosis, 120 
Peart, Margaret L., 639, 104 
Pediatric nurse and plav therapy (Pinker- 
ton), 28 



19 



Pediatric nursing : 

Cleft lips and palates (Hill), 439 

Hurler's disease (Philippe), 1122 

Mongolism (Nelson), 452 

The pediatric nurse and plav therapv 
(Pinkerton), 28 

Prevention and control of cross-infection 
in the nursery of the normal newborn 
(Z wicker), 797 

Pyloric stenosis (Pavan), 120 

A research project in a premature nursery 
(Jones). 432 

Staphylococcal diseases in infancy (Ro- 
binson), 794 
Pediatric surgical nursing (Desjardins), 896 
Pkdiatrie : 

Maladie de Hiirler (Philippe), 431 

Les maladies staphylococciques chez les 
nourrissons (Robinson), 215 

Prevention et controle de I'infection mixte 
a la pouponniere du nouveau-ne (Zwic- 
ker), 217 
Pellicule de polythene : danger de mort 

(Jeffrey), 395 
Pemphigus vulgaris (Sobie), 627, 114 
Peptic ulcer (Eldridge), 114 
Perfection through practice (Tardif), 899 
Le Perfectionxemext par I'exercice, (Tar- 
dif), 276 
Perret, Shirley 

Spina bifida and hydrocephalus, 1111 

Le spina-bifida et I'hydrocephalie, 369 
Personai,, impersonal and i)itcrpcrsoiial re- 
lations {Burton) , (rev.), 653, 190 
Phenomexes metaboliques : 

Maladie de Hiirler ( Philippe), 431 
Philippe, Marilyn 

Hurler's disease, 1122 

Maladie de Hurler, 431 
Pilot project : 

Board of review, 156 

Bureau de revision, 158 

Comment faire connaitre le. 160 

Institutes and workshops, 632, 712 

Interpreters of the, 154 

Membership, board of review, 340, 343 

Portefeuille sur le projet d'accreditation, 
248 

Study folio on accreditation, 244 

Surveys completed, 340, 343 
Pixkertox, Patricia A. 

The pediatric nurse and i)lay therapy, 28 
Plan de retraite : 

Comment vous pouvez aider (Beaudin), 
59 
Planning a demonstration night (Colvin, 

Jones, Mitchell), 938 
Plan XI xc, senior experience in obstetrics 

(Mann), 1003 
Plastic film : 

Death from, (Jeffrey), 1096 
Plastic surgerv : 

Cleft lips and palates (Hill), 439 
Play therapy : 

The i)ediatric nurse and, (Pinkerton), Id^ 
Pxeumoxia : 

Right lobar, (Eaton), 1108 
Pneumonia (de la Mare), 1105 
Pneumonie: 

lobaire (Eaton), 416 
Traitement de la, ( Delisle), 412 
Pneumonie, la (de la Mare), 413 
Pneumonie lobaire (Eaton), 416 
Poem : 



The nurse's life (Munro), 356 
Prelude to a report (M. E. ), 838 
The registrar (Gavin), 164 
Poeme : 

Les dix commandements de la future ma- 
man (Thibault), 33 
Voix secretes (Grenier), 435 
Poisons : 

L'acide borique — ou le loup sous la 

peau d'une brebis (Halliday), 392 
Boracic acid — the wolf in sheep's cloth- 
ing (Halliday), 1093 
Liste d'antidotes essentiels, 394 
The problem of, (Dean), 1091 
Le probleme des, (Dean), 389 
Table of antidotes, 1095 
Poland, Fred W. 

La crampe des ecrivains, 32 
Writer's cramp, 523 
Poole, Pamela Eleanor & por., 527, 35 
De grandes attentes (ed.), 265 
Great expectations (ed.), 889 
Posture : 
and the school age child (Henrichon), 

826 
Le maintien de I'enfant d'age scolaire 
(Henrichon), 240 
Posture and the school age child (Henri- 
chon), 826 
Potts, Dorothy A., ZiZ 

Pour ne pas lever le coude (Croken), 101 
PouRQUOi et comment ecrire, 239 
PouRQUOi les juger ( Ste. Mechtilde), 339 
Practical suggestions : 
Audio-analyzer, 1082 
Clinilab, 878 
Disposable clothing, 847 
Disposable plastic container with a de- 
tachable medicine-card safety-cap, 690 
Don't bend an elbow (Croken), 744 
Linenmobile, 1030 

Mechanical floor cleaning equipment, 1138 
A new medication setup (Morley), 312 
A new orthopedic brace (Graydon), 350 
Rotary glove washers, dryers and pow- 

derers, 1054 
Sawdust beds (Bourns), 162 
Silicone ointments, 1094 
Synthetic casualties, 213 
Textile magic marker, 909 
Tri-Top thermometers, 843 
Pre-Eclamptic toxemia (Goos, Sellers, An- 

toniades), 1005 
Prelude to a report (M. E.), 838 
Prematurity : 

A research project in a premature nursery 
(Jones), 432 
Preparation for nursing in cardiac surgerv 

(Parent), 902 
Presley, Florence G. (Creighton, Hufnagel, 
Thorn) 

Entraide au-dela de la frontiere, 21 
Prevention des accidents : 
L'acide borique — ou le loup sous la peau 

d'une brebis (Halliday), i92 
Liste d'antidotes essentiels, 394 
Pellicule de polythene : danger de mort 

(Jeffrey). 395 
Le probleme des poisons (Dean), 389 
Soyons prudentes — prevenons les acci- 
dents au foyer (Robertson), 396 
Prevention and control of cross-infection 
in the nursery of the normal newborn 
(Zwicker), 797 



-13- 



Prevention et controle de I'infection mixte 

a la pouponniere du nouveau-ne (Z wic- 
ker), 217 
Prevention des infections staphylococciques 

a la salle d'operation (MacNeill), 219 
Prevention of staphylococcal infections in 

the operating room (MacNeill), 799 
Price, Philip B. 

Skin antisepsis, 222 
Prince Edward Island : 

News notes, 71 

Provincial roundup, 354 
Principles of ethics (Moore, Stevens), 

(rev.), 654, 125 
Problem of burns (Christie), 912 
Problem of poisons (Dean), 1091 
Problem of staphylococci in the operating 

room and central supply room (Smith), 801 
Probleme des brulures, le (Christie), 288 
Probleme et controle des infections a sta- 

phylocof|ues (Rose), 213 
Problems des poisons, le (Dean), 389 
Probleme des staphylocoques a la salle d'o- 
peration et au service central, le (Smith), 

221 ^ 
Problemes professionnels : 

Sous de fausses couleurs (MacGregor), 
118 
Problemes sociaux : 

Pourquoi les juger (Ste. Mechtilde), 339 
Procedures parlementaires : 

L'organisation et la conduite d'une as- 
semblee (Duplain), 143 
Professional activities : 

Five years of progress (Story), (ed.), 599 

Nursing in New Brunswick (Smith), 
(ed.), 199 
Professional development : 

Building on our likenesses (Rossiter), 
(ed.), 407 

Five years of progress (Story), (ed.), 599 

A new milestone (Wheeler), (ed.), 503 

Our golden jubilee (Gerard), (ed.), 783 
Professional ideals : 

The dignity of service (Kerr), (ed.), 303 

Faith and loyalty (Riley), 39 

.A. letter to my niece (Zalloni), 728 

The meaning of faith (Girard), (ed.), 13 

The other three R's (Hickman), 516 
Professional problems : 

The meaning of faith (Girard), (ed.), 13 

Under false colors (MacGregor), 633 
Program planning, 105 
Programme de rehabilitation, le (Pakal- 

nins), 293 
Programmes scolaires : 

L'aspect communautaire et le nursing 
(Du Gas, Blackwood), 298 

Enseignement de base en nursing chirurgi- 
cal (Dusseault), 270 

Formation superieure en nursing chirurgi- 
cal (Rheault), 281 

Instruction clinique a I'etudiante en nurs- 
ing chirurgical (Ouimet), 2(57 

Le nursing chirurgical pediatrique (Des- 
jardins), 272 

Le perfectionnement par I'exercice (Tar- 
dif), 276 

Une seance de demonstrations (Colvin, 
Jones, Mitchell), 371 
Projet d'evaluation, 110, 161 
Provincial Association headquarters : 

A dream comes true (Van Dusen), (ed.), 
103 



Provincial roundup, 352 

Psychiatric aide (Robinson), (rev.), 1148, 

437 
Psychiatric conditions : 
Involutional melancholia (Gibson), 1028 
The manic-depressive psychosis (Gibson). 

928 
Mental effects of head injurv (Gibson), 

1118 
Schizophrenia (Gibson), 830 
Psychiatric nursing: 

Emotionally disturbed patients (Ward), 
1144 
Psvchiatrie: 

Malades aux troubles emotifs (Ward), 

244 
La, et I'enfant (Statten), 98 
PsYCHiATRiE et I'enfant, la (Statten), 98 
Psychiatrist and the child (Statten), 620 
Psychiatry : 

Nursing in psychiatric divisions of general 

hospitals (McCrimmon), 250 
The psychiatrist and the child (Statten), 
620 
Psychology for nurses (Sheehv, Harmon), 

(rev.), 747, 252 
Psychology of carix childhood (Landreth), 

(rev.), 360 " 

Psychose maniaco-depressive, la (Gibson), 

296 
Public health : 
The venereal disease clinic (Schroeter), 

42 
Work on Okinawa (Carniel), 40 
Public health nursing : 
An analysis of home visits to newborn 
infants made by the public health nurses 
(Carpenter), 809 
Home visiting and maternal health (Doy- 

on), 700 
In step with modern progress (Gagnon), 

988 
Posture and the school age child (Henri- 

chon), 825 
The responsibilities of the public health 

nurse (Doyon), 635 
The role of the nurse-midwife in Great 

Britain (Mills), 995 
Supportive maternal and child care (Cun- 
ningham ) , 990 
PuF^RicuLTURE sociale : 

Soins de soutien de la mere et I'enfant 
( Cunningham ) , 327 
Pyloric slenosis (Pavan) 120 



Quebec : 

Actualite et perspective (Tremblay), 434 

News notes, 465 

Provincial roundup, 354 
QuiNE, G. (rev.), 746, 251 
Quirk. Madeleine 

Alberta Certified Nursing Aide Associa- 
tion, 254 



Rabies, 558 
Rackham, Judith, C. 

The artificial kidney, 716 

Le rein artificiel. 165 
Raniwm comments, 304, 496, 592, 681. 776, 

880, 980, 1081 



—14— 



Readaptation : 

Le programme de rehabilitation (Pakal- 
nins), 293 
Rf.cherches en nursing : 

Analyse des experiences personnelles de 
huit cardiaques pendant un sejour dans 
un hopital general (Allemang), 151 
Analyse des visites aux nourrissons (Car- 
penter), 229 
Le besoin d'entreprendre des, (Fidler), 

41 
La nature de la, (Uprichard), 66 
Redaction d'articles : 

La crampe des ecrivains (Poland), 32 
Pourquoi et comment ecrire, 239 
Red Cross fellowship, 223 
Reed, Howard 

Squint or strabismus, 16 
Reflexions pour la vigile de Noel (Gi- 

roux), (ed.), 387 
Registrar (Gavin), 164 
Rehabilitation : 

of Mrs. Moritz (Butler), 215 

The story of Johnny (Miller), 214 

The, program (Pakalnins), 922 

Teaching esopliageal speech (Stocklev), 

310 
in a teaching program (Crawford, Heie- 

ren), 201 
The, team (McColl), 210 
We teach — do our patients learn (Mac- 
Arthur), 205 
Rehabilitation in a teaching program 

(Crawford, Heieren), 201 
Rehabilitation of Mrs. Moritz (Butler), 

215 
Rehabilitation program (burns), (Pakal- 
nins), 922 
Rehabilitation team (McColl), 210 
Reid, Alma E. (rev.). 258 
Rein artificiel, le (Rackham), 165 
Relationship between the quality of nursing 

care and its cost (Decary), 521 
Relaxation (James), 325 
Relieving pressure on acute wards, 1119 
Renal transplant — nursing care (Harris, 

Dossetor), 508 
Renal transplantation in identical twins 

(MacKinnon), 506 
Research, 30, 139, 224, 318, 338, 341, 432, 

702, 809 
Research : 

An analysis of the experiences of eight 
cardiac patients during a period of hos- 
pitalization (.-Mlemang), 702 
.■\n analysis of home visits to newborn 
infants made by the public health nurses 
in the East York-Leaside Health Unit, 
Ontario (Carpenter), 809 
Areas of needed, 338 
Ad hoc committee on, 242 
Committee personnel, 540 
The master plan of rotation (Street), 30, 

139 
The nature of, (Uprichard), 318 
The need for, in nursing (Fidler), 224 
A, project in a premature nursery (Jones), 

432 
In step with modern progress (Gagnon), 
989 
Research in nursing (Brown), (rev.), 256 
Research project in a premature nursery 

(Jones). 432 
Responsabilites de I'infirmiere-hygieniste, 



les ( Doyon ) , 95 
Responsabilites professionnelles : 

Actualite et perspective (Tremblay), 434 
Responsibilities of the public health nurse 

(Doyon), 635 
Retirement plan, 244, 444, 524, 713, 1116, 

1117 
Retirement plan : 

Application for participation in the, 1117 

The CNA, becomes a reality (Beaudin), 
329 

How you can help (Beaudin), 524 

Ideal, for nurses, 1116 

Scope broadened, 330 
Retraite, plan de, 248. 448 
Reynolds, Jeanne 

Is nursing at the service of patients, 513 

Le nursing est-il au service du malade, 
13 
Rheault, Sister Claire 

Advanced preparation in nursing, 904 

Formation superieure en nursing chirurgi- 
cal, 281 
Right lobar pneumonia (Eaton), 1108 
Riley, Martha 

Faith and loyalty, 39 
Robertson, Irene Margaret & por., 528, 36 

Get down to brass tacks — prevent home 
accidents, 1097 

Soyons prudentes — prevenons les acci- 
dents au foyer. 396 
Robertson, R. W. (rev.), 840, 310 
Robinson, Alice ^I. 

The psychiatric aide (rev. ). 1148, 437 
Rob I. \ son, Barbara 

Les maladies staphylococciques chez les 
nourrissons. 215 

Staphylococcal diseases in infancy. 794 
Role de I'infirmiere-sage-femme en Grande- 

Bretagne. le (Mills), 334 
Role of the nurse-midwife in Great Britain 

(Mills), 995 
Rose, Sister Annette 

The control of staphvlococcal infections, 
795 

Problemes et controle des infections a 
staphylocoques, 213 
RossiTER, Edna Elizabeth, 396, (por.), 407 

Building on our likenesses ed.), 407 
RossMAN, I. J. (Schwartz) 

The family handbook of home nursing and 
medical care (rev.), 652, 189 
Rotation : 

Master plan of. (student). (Street). 30, 
139 
Rougi, Anne (rev.). 250 
Rowland, Patricia 

Nursing care in hemorrhoidectomy, 123 
Rutledge, E. 

Erythroblastosis fetalis, 1022 

Erythroblastose foetale, 365 
Rynbergen, Henderika J. (Cooper, Barber, 

Mitchell) 

Nutrition in health and disease (rev.). 746 
251 



ST-Jean-Eudes, Soeur 

Manuel de nutrition et de diciotherapie 
(rev.), 125 
Ste. Mechtilde, Sister, (por.) 339,999 

Pourquoi les juger. 339 

Why judge them. 999 



—15- 



Safety education : 

Boracic acid — the wolf in sheep's cloth- 
ing (Halliday). 1093 
Death from plastic film (Jeffrey), 1096 
Get down to brass tacks — prevent home 

accidents (Robertson), 1097 
Highway deaths, 1054 

The problem of poisons (Dean), 1091 
Table of antidotes, 1095 
Safety signs for mental health (Steven- 
son), 907 
Sagesse, Sister Elisabeth Marie de la 
Anemie hemolytique familiale, 112 
Familial hemolytic anemia, 641 
Salle d'operation, a la (Szmidt), 292 
Sanders, V. M. (rev.), 358 
Sans bornes et sans fins (MacGregor), 120 
Sante mentale: 

La psychiatric et I'enfant (Statten), 98 
Saskatchewan : 

Annual meeting in, (Antonini), 842 
Assemblee annuelle en, (Antonini), 245 
News notes, 71, 168, 267, 369, 466 
Provincial roundup, 354 
Save yourself three cents, 1090 
Sawdust beds (Bourns), 162 
Sawyek, Janet R. (Shafer, McCluskey, Lif- 
gren) 

Medical-surgical nursing (rev.), 652, 189 
Schizophrenia (Gibson), 830 
ScHizoPHRENiE, la (Gibson), 242 
Schroetek, Magdalene 

The venereal disease clinic, 42 
Schumacher, Marguerite Eva 

The adviser to schools of nursing, 2>il 
Schutt, Barbara G. & por., 637, 102 
Schwartz, Doris R. (Modell) 
Handbook of cardiology for nurses (rev.), 
562, 126 
Schwartz, Doris R. (Rossman) 

The family handbook of home nursing and 
medical care (rev.), 652. 189 
Schweisheimek, W. 

How hospital personnel feel about nursing 
care, 456 
SciENTiiic principles in nursing (McClain, 

Gragg), (rev.), 560, 128 
Seance de demonstrations, une (Colvin, 

Jones, Mitchell), 371 
Seeds, Irene Bernice, 36 
Selleks, Marian (Goos, Antoniades) 
Pre-eclamptic toxemia, 1005 
Toxemic pre-eclamptique, 349 
S'en servir, oui ou non (Lindsey). 186 
Service de nursing : 
Analyse des experiences personnelles de 
huit cardiaques pendant un sejour dans 
un hopital general (Allemang), 151 
Des cours d'entrainement pour la certifica- 
tion de I'infirmier (Dick, Carruthers), 
184 
De grandes attentes (Poole), (ed.), 265 
Interdependance du cout quotidien du nurs- 
ing et de sa qualite (Decary), 30 
Le nursing est-il au service du malade 

(Reynolds), 13 
Prevention des infections staphylococciques 
a la salle d'operation (MacXeill), 219 
Le probleme des staphylocoques a la salle 
d'operation et au service central 
(Smith), 221 
Shackleton, Alberta Dent 

Nutrition manual for nurses (rev.), 360 
Shafer, Kathleen Newton (Sawyer, Mc- 



Cluskey, Lifgren) 

Medical-surgical nursing (rev.), 652, 189 
Shaw, Ethel Crawford & por., 132 
Sheehy, Sister M. (Harmon) 

Psychology for nurses (rev.), 747, 252 
Silver anniversary (University of Toronto), 

48 
Sisters (See under given name or sur- 
name ) 
Skin antisepsis (Price), 222 
Skin conditions : 

Pemphigus vulgaris (Sobie), 627 
Small, Muriel E. (rev.), 748, 309 
Small patients ( (Soldbloom ) , (rev.), 1049, 

376 
Smith, Doris Harriet & por., 637, 103 
Smith, Lois O. (por.), 188 

Nursing in New Brunswick (ed.), 199 
Smith, Alerle 

The problem of staphylococci in the oper- 
ating room and central supply room, 801 
Le probleme des staphylocoques a la salle 
d'operation et au service central, 221 
Smith, Roselyn & por., 908, 284 
Snidal, Ellen 

Nursing care in a mitral commissurotomy, 
421 
Sobie, Gloria 

Pemphigus vulgaris, 627, 114 
Social problems : 

Why judge them (Ste. Mechtilde), 999 
SoEURS (voir ci-dessous, prenom ou nom de 

famille) 
SoiNS a domicile : 
Une analyse de la visite a domicile en 
sante maternelle (Doyon), 148 
SoiNS infirmiers a donner aux lesions ther- 

miques, les (Virginia), 417 
SoiNS infirmiers : 

Anemie hemolytique familiale (Sagesse), 

112 
Un aspect moderne du soin des malades 

(Flanagan), 163 
Cancer du sein droit (Johnston), 175 
Un cas d'hepatite infectieuse (Trenchard), 

61 
La cetose diabetique, (Dahl), 302 
Dans la salle (Lepot), 259 
Les, a donner aux lesions thermiques (Vir- 
ginia), 417 
Diverticule oesophagien (Myers), 91 
Entraide au-dela de la frontiere (Creigh- 
ton, Hufnagel, Thorn, Presley), 21 
Erythroblastose foetale (Rutledge), 365 
individualises (MacLeod), 288 
Infarctus du myocarde (McDermid), 85 
Maladie de Hurler (Philippe), 431 
Nursing chirurgical en cardiologie (Pa- 
rent), 279 
Le nursing est-il au service du malade 

(Reynolds), 13 
Pemphigus vulgaris (Sobie), 114 
Pneumonic lobaire (Eaton), 416 
Pour ne pas lever le coude (Croken), 101 
Problemes et controle des infections a 

staphylocoques (Rose), 213 
Prophylaxie des plaies de lit, 410 
Le rein artificiel (Rackham). 165 
de soutien de la mere et I'enfant (Cun- 
ningham), 327 
Le spina-bifida et I'hydrocephalie (Fer- 
ret), 369 
Toxemic pre-eclamptique (Goos, Sellers, 
Antoniades), 349 



-16— 



Traitenient de la pneumonie (Delisle), 412 

Ulcere gastrique malin (Parrent), 178 

SoiNS infirmiers, les (Harris, Dossetor), 

19 
Soixs infirmiers individualises (MacLeod), 

288 
SoiNS de soutien de la more et I'enfant (Cun- 
ningham), 327 
SoiNS d'urgence : 

Liste d'antidotes cssentiels. 394 
Sous de fausses couleurs (MacGregor), 

118 
Sous Ic regard dc Dieu (Killian), (rev.), 

251 
SouTHERN-HoLT, Mary 

L'infection staphylococcique, 210 
Staphylococcal infection, 791 
SoYONS prudentes — prevenons les acci- 
dents au foyer (Robertson), 396 
SprxA-bifida et riiydrocephalie, le (Perret), 

369 
Spina bifida and hydrocephalus (Perret), 

1111 
Squint or strabismus (Reed), 16 
Squires, Ada Thomas &- por., 1129, 423 
Staphylococcal diseases in infancy (Robin- 
son), 794 
Staphylococcal infection (Southern-Holt), 

791 
Staphylococcus : 

About the, (Murray). 787 

The control of staphylococcal infections 

(Rose), 795 
Hospital sepsis : a communicable disease, 

1126 
Prevention and control of cross-infection in 
the nursery of the normal newborn 
(Zwicker), 797 
Prevention of staphylococcal infections in 
the operating room (MacNeill), 799 
The problem of staphylococci in the oper- 
ating room and central supply room 
(Smith), 801 
Staphylococcal diseases in infancy (Robin- 
son), 794 
Staphylococcal infection (Southern-Holt), 
791 
Staphylocoqui: : 

L'infection staphylococcique (Southern- 
Holt), 210 
Les maladies staphylococciques chez les 

nourrissons (Robinson), 215 
Prevention et controle de l'infection mixte 
a la pouponniere du nouveau-ne (Zwic- 
ker), 217 
Prevention des infections staphylococ- 
ciques a la salle d'operation (MacNeill), 
219 
Le probleme des, a la salle d'operation et 

au service central (Smith), 221 
Problemes et controle des infections a, 
(Rose), 213 
Stapiiylocoque, le (Murray), 205 
Statten, Taylor 

La psychiatric et I'enfant, 98 
The psychiatrist and the child, 620 
Stevens, Gregory (Moore) 

Principles of ethics (rev.), 654, 125 
Stevenson, George S. 
Mental health hazards in later life, 414 
Safety signs for mental health, 907 
Stock, Joan, 1034 
Stockley, M. 

Teaching esophageal speech, 310 



Story, Janet S., 588, (por.), 599, 68, 73 

Cinq annees de progres (ed. ), 73 

Five years of progress (ed.), 599 
Story of Johnny (Miller), 214 
Street, Margaret M. 

The master plan of rotation, 30, 139 
Suggestions pratiques: 

L'adressographe, 405 

Appareil audiometrique, 391 

Carton medical et le capuchon. 111 

Clinilab, 316 

Dot-gum-pen, 255 

Literie mobile, 433 

Materiel s de nettoyage de plancher, 391 

Polyethylene marlex, 410 

Pour ne pas lever le coude (Croken), 101 

Le ressussitube, 253 

Tri-top therniometre, 187 
Supportive maternal and child care (Cun- 
ningham), 990 
Surgery for nurses (Moroney), (rev.), 462 
Surgery for students of nursing (Cairney), 

(rev.), 462 
Sutton, Isabel M. & por., 529, 40 
SwENSON, Ruth P. Stewart (Montag) 

Fundamentals in nursing care (rev.), 1146, 
436 
SzMiDT, Patricia 

In the operating room, 918 

A la salle d'operation, 292 



Table of antidotes, 1095 
Tardif, Colette 

Perfection through practice, 899 
Le perfectionnement par I'exercice (Tar- 
dif), 276 
Tate, Barbara & por., 637, 102 
Teaching community aspects of nursing 

(Du Gas. Blackwood), 932 
Teaching methods : 

Basic teaching in surgical nursing (Dus- 

seault), 891 
Clinical teaching in surgical nursing (Oui- 

met), 893 
Pediatric surgical nursing (Desjardins), 

896 
Perfection through practice (Tardif), 899 
Rehabilitation in a teaching program 

(Crawford, Heieren), 201 
Teaching community aspects of nursing, 
their inclusion in the basic curriculum 
(Du Gas. Blackwood), 932 
Tenue d'un hopital, la (Wickens), 400 
Terreneuve: (\'oir aussi Newfoundland) 
Cinq annees de progres (Story), (ed.), 
73 
Textbook of anatomy and physiology (An- 
thony), (rev.), 1050. j?75 
Thibault, Lucille 
Les dix comniandements dc la future ina- 
man, 33 
This is Canada (Young), 601 
Thompson, La Verne 

Microbiology and epidoniohx/v (rev.), 
560, 127 
Thomson, William A. R. 

Black's medical dictionary (rev.), 840, 
309 
Thorn, Juanita (Creighton. Hufnagel, Pres- 

Entraide au-dela de la frontiere, 21 
To use or not to use (Lindsey). 1142 



—17— 



Tourniquet : 

To use or not to use (Lindsey), 1142, 186 
ToxKMiE pre-eclamptique (Goos, Sellers, 

Antoniades), 349 
Traitement de la pneumonie (Delisle), 

412 
Transplantation renale chez des jumelles 

identiques (MacKinnon), 17 
Tremblay, J. N. 

Actualite et perspective, 434 
Trenchard, Mavis 

Un cas d'hepatite infectieuse, 61 

Infectious hepatitis, 552 
Trenholm, Vida 

Coronary artery thrombosis, 428 
Tribune des lectrices, la, 8, 71. 136, 197, 262, 

318, 384 
Trois autres R — ces inconnus, les (Hick- 
man), 24 
Trudei,, Juliette 

Visite a I'ecole de puericulture de Paris, 
France, 310 
TscHUDiN, Mary (Belcher, Nedelsky) 

Evaluation in basic nursing education 
(rev.), 256 

u 

Ulcere gastrique malin (Parrent) , 178 
Under false colors (MacGregor), 633 
UNESCO : 

Mission to Japan (Naudett), 128 
University of Toronto School of Nursing 

— silver anniversary, 48 
Unmarried mothers : 

Why judge them (Ste. Mechtilde), 999 
Uprichard, Muriel 

La nature de la recherche, 105 

The nature of research, 318 
Usage des loisirs, 1', 254 
Use of leisure : 

What will you do with that shorter work 
week, 804 



Van Dusen, Clara, 92 

Annual meeting in Alberta, 1046 

Assemblee annuelle en Alberta, 343 

A dream comes true (ed.), 103 
Varicose veins : 

Nursing care in hemorrhoidectomy (Row- 
land), 123 
Venereal disease : 

The, clinic (Schroeter), 42 
Venereal disease clinic (Schroeter), 42 
Vianney, Sister Marie (rev.). 560, 63 
\'ictorian Order of Nurses : 

Appointments, transfers, resignations, 60 

The rehabilitation of Mrs. Moritz (But- 
ler), 215 
Virginia, Soeur M. 

Les soins infirmiers a donner aux lesions 
thermiques, 417 
Visite a I'ecole de puericulture de Paris. 

France (Trudel), 310 
YisnY. chez nos voisines, en (MacGregor), 



(ed.), 321 
\'jsiTiNG our neighbors (MacGregor), 

(ed.). 985 
\'oicE of the past, 1133 
Voici le Canada (Young), 75 
Voix du passe, la, 426 
Voix secretes (Grenier), 435 
Voyage en Europe, 55 
\'rooman, Laura, 234 



w 



Ward, Mrs. B. 

Emotionally disturbed patients, 1144 

Malades aux troubles emotifs, 244 
Waters, Moir A. J. 

A paraphrase of Paul's thirteenth chapter 
of First Corinthians for nurses, 746 
Watt, Jean Cockburn & por., 530, 38 
We teach — do our patients learn (Mac- 
Arthur), 205 
Wedgery, Albert W. & por., 1130, 424 

The past has a future, 135 
Welcome to L'Infirniicrc Canadiennc (Gi- 

rard), 505 
What will you do with that shorter work 

week, 804 
Wheeler, Margaret May, 492, & por., 503 

4, 11 

A new milestone (ed.), 503 
Why judge them (Ste. Mechtilde), 999 
Wickens, R. N. 

Hospital housekeeping, 1 100 

La tenue d'un hopital, 400 
Wild, Dorothy Anne «&: por., 2)26 
Wilkes, Edward T. 

Faniilv guide to teenage health (rev.), 
747." 309 
Wilson, Lola, 242, 246, 338 
Wood, Ella J. & por., iZ7 
Wright, Alice L. 

Annual meeting in British Columbia, 846 

Assemblee annuelle en Colombie-Britan- 
nique, 247 
Wright, F. Howell (Jeans, Blake) 

Essentials of pediatrics (rev.), 560, 63 
Wright, K. (rev.), 560, 128 
Writer's cramp (Poland), 523 
Wyatt, Jean 

Medicine man, 46 



Young, Morley A. R. 
This is Canada, 601 
Voici le Canada, 75 



Zalloni, Therese 

A letter to my niece, 728 
Lettre a ma niece, 181 
Zwicker, Patricia 

Prevention and control of cross-infection 

in the nursery of normal newborn, 797 

Prevention et controle de I'infection mixte 

a la pouponniere du nouveau-ne, 217 



PHOHB 



CAi-l- 



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TIFAE: 9a5_a_i. 



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M ' ' y 1 oc Ointment in 



JANUARY. 1959 • Vol. 55. No. 1 



THE CANADIAN NURSE 



VOLUME 55 



NUMBER 1 



JANUARY 1959 



4 Betwkfx Ourselves 

6 New Products 

1 3 The Meaning of Faith Alice Girard 

16 Squint or Strabismus Howard Reed 

21 Entraide Au-Dela de la 

Frontiere H. Creighton, C. A. Hujnagel, J. Thorn, 

'•- F. G. Presley 

28 The Pediatric Nurse 

AND Play Therapy P. A. Pinkcrton 

29 InMemoria.m 

30 The Master Plan ov Rotation Margaret M. Street 

36 Nursing Profiles 

39 Faith and Loyalty Martha Riley 

4-0 Health Work on Okinawa Sr. Mary Carmel 

42 The Venereal Disease Clinic Magdalene Schroeter 

46 Medicine Man Jean IVyatt 

62 Nursing Across the Nation 
56 Le Nursing a travers le pays 
66 News Notes 
T2 Employment Opportunities 



Editor and Business Manager 
MARGARET E. KERR. M.A., R.N. 

Assistant Editor 
JEAN E. MacGREGOR. B.N.. R.N. 



Subscription Rates: Canada & Bermuda: 6 months $1.75; one year, $.5.00; two years, $5.00. 

Student nurses — one year. $2.00; three years, $5.00. U.S.A. & foreign: one year, $3.50; two years. $6.00. 

In combination with the American Journal of Nursing or Nursing Outlook: one year, $7.00. 

Single copies, 35 cents. 

Make cheques and money orders payable to Tlie Canadian Nurse 

Change of address: Four weeks' notice and the old address as well as the new are necessary. 

Xot responsible for Journals lost in mail due to errors in address. 

Authorized as .'^econd-Class Mail. Post Office Department, Ottawa. 

Advertising Representatives: W. F. L. Edwards &: Co. Ltd., .^4 King St. E., Toronto I, Ont. 

Walter Slack, 801 Public Ledger Building. Pliiladelphia 6, Pa. 

Member of Canadian Circulations Audit Board. 

I^T 1522 SttcrbrookerrStr^t West, WhSSTrear25,' Quebec 



The z'iezcs expressed 
in the various articles 
arc the Z'iezvs of 
the authors and 
do not necessarily 
represent the policy 
or I'ieii's of 

The Canadian Nurse 
nor of the Canadian 
Nurses' Associatio)i. 



THE CANADIAN NURSE 



Developed to meet your standards — 

Morning Milk 

...the partly-skimmed milk 
guaranteed by Carnation 




ANOTHER CARNATION QUALITY PRODUCT . . , 



Your recommendation of 
partly -skimmed Morning 
Milk is protected by the 
time -proven quality con- 
trols that have made 
Carnation Milk the accept- 
ed milk for full-fat infant 
feeding : 

NOURISHING AND DIGESTIBLE: 

Standardized to exact 
levels of fat content and 
Vitamin D. 

UNIFORM: Rigid laboratory 
controls provide the same 
high quality in every can. 

SAFE: Only finest inspected 
milk is accepted, production 
is continually supervised, 
and Morning Milk is pro- 
tected by Carnation's spe- 
cial evaporated milk can. 




JANUARY. 1959 • Vol. 55, No. 1 



^etcu^ee^t^ Ou^ueit/^e^ 



Watchwords have liad a long and interest- 
ing history of use in military circles where 
they served as the secret or code words to 
identify friends. Without the correct pass- 
word no person could gain admittance to the 
ancient beleaguered castle, the military en- 
campment or, even today, to any closely 
guarded zone. 

In modern times a new meaning has been 
ascribed to watchword. It is now interpreted 
as a phrase or a single word that expresses 
belief in the principles of an organization. 
In the nursing world, the watchword given 
to the International Council of Nurses by 
the out-going president. Mile Marie M. 
Bihet in 1957 was Wisdom. 

Last June our new national president, 
Miss Alice Girard, in her initial address 
gave the nurses of Canada a watchword for 
this biennium — Faith. To attempt an ade- 
quate definition of what is meant by that 
word is not an easy task. The dictionary 
gives half a dozen dififerent interpretations 
each of which, again, would require a care- 
ful analysis — trust and confidence in an- 
other ; fidelity, loyalty ; honesty. W^hich did 
our president mean ? 

Following the tradition of a great many 
years Miss Girard, as guest editor, has given 
us a very sound understanding of the mean- 
ing of faith. Let us respond to her lead in 
our devotion to every aspect of our pro- 
fessional work. 

* * * 

Commonly called "crossed eyes" or a 
"lazy eye," strabismus is usually due to the 
fact that the eyes are not seeing objects 
clearly when used together. To overcome this 
difficulty one eye is unconsciously turned 
away from the object that is being viewed. 
This squint may be due simply to a need for 
glasses. When a properly fitting pair is 
worn regularly the squint may be improved 
or entirely corrected. 

Since strabismus usually becomes apparent 
in childhood, especially following an illness, 
every nurse has an obligation to be observant, 
to be familiar with the care that should be 
given and to advise parents on the i)roper 
course to follow. Dr. Howard Reed supplies 
the information that nurses rec|uire to be 



cognizant of their important role. 

* * * 

.\ continuing problem in every school of 
nursing, large or small, is to organize tiie 
student rotation in such a manner that every 
student will receive her full share of e.\- 
perience in every department without being 
side-tracked to fill gaps in the service needs 
of the hospital. Sometimes the director of 
nursing herself undertakes the task of ar- 
ranging the rotation schedule ; sometimes it 
is developed by the chief instructor. It may 
be a thoughtfully constructed pattern or it 
may even be a rather hit-and-miss afifair. 

Miss Margaret Street describes in careful 
detail a master plan of rotation, which if 
followed closely would assist any nurse re- 
sponsible for the rotation of students to 
accomplish her task with a degree of com- 
petence that would increase with each new 
class. 

* * * 

The Ontario Department of Health has es- 
timated that some 800 of all the babies born 
in that province each year will be suffering 
from hemolytic disease of the newborn. 
Though there is no known means of pre- 
venting the occurrence of this condition, 
the studies that laboratories can make by 
examining the pregnant woman's blood will 
enable them to predict whether the infant 
will or will not have erythroblastosis. With 
this knowledge, adequate early treatment can 
be instituted that will ensure survival and 
normal development for nearly 100 per cent 
of the affected infants. 

.A. survey undertaken two years ago reveal- 
ed that there were many areas in Ontario 
with insufllicient laboratory facilities for ttie 
investigation of this disease and with no 
personnel trained in the technique of its 
treatment. Happily, this situation has been 
corrected. Centres for investigation and 
treatment are now established throughout 
the province, so that all physicians now have 
these services available for their patients. 
Every Ontario mother, no matter where she 
lives, by consulting her doctor early in her 
pregnancy is assured of all that modern 
medicine can provide in the management of 
this disease. 



The ant finds kingdoms in a foot of 
ground. — Stephen- Vixcent Benet 



She was as immutable as the hills but not 
quite as green. — Rudy.ard Kiplixc; 



THE CANADIAN NURSE 



for your own and your patients' skin care 

pfeventsjelieves rough, dry skin 




. . . ideal after "scrub-ups 



for "detergent hands" 



dermatoses 



powder base, chafing, chapping . . . 



fii^/iza 0*e/ne 



smooth-spreading . . . quickly alisorbed 
2^/3 oz. tube, 4 and 15 oz. jars 



COMPANION 
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VANZA 
SUPERFATTED SOAP 

for sensitive or 

dry skin; fine, also, 

for nursery use. 



Soothing, emollient Vanza Creme forms a thin, 
protective, non-greasy film which protects against 
dehydration ... "lubricates" with a cholesterinized 
water-in-oil emulsion. 

MAIL COUPON FOR FULL-SIZE TUBE 

VanZant & Co., Limited, Dept. CN-2 
357 College Street, Toronto, Ontario 

Please mail me free of charge a complimentary tube of \'anza 
Creme and guest size \anza Superfatted Soap. 



crrv PRov. 



JANUARY. 1959 • Vol. 55. No. 1 



Edited by DEAN F. N. HUGHES 

Published Through Courtesy of Canadian Pharuiacciitical Journal 

BRONKASMA TABLETS 

Description — Each tablet contains: Theophylline (anhydrous) (IV2 gr.) 100 mg. 
ephedrine sulphate (S/s gr.) 24 mg. phenobarbital (Vs gr.) 8 mg. thenyldiamine hydro- 
chloride (1/6 gr.) 10 mg. glyceryl guaiacolate (IV2 gr.) 100 mg. 

Indications — Treatment and control of the asthmatic attack. 

Administration — Adult dosage: One tablet every 3 or 4 hours. 

Children: According to age. 

BUFFERGEL 
Manufacturer — Anglo-Canadian Drug Company Ltd., Oshawa. 
Description — Tablets: Aluminum hydroxide gel dried 10 gr, magnesium hydroxide 

5 gr. liquid, aluminum hydroxide gel U.S. P. XIII 1 fl. oz., magnesium hydroxide 13 gr. 

Indications — As a gastric antacid and adsorbent without tendency to constipate. 
Buffering effect continues over 2 hours. 

Administration — One dessertspoonful of liquid or 1 tablet 3 times daily after meals. 
Frequency may be increased in peptic ulcer to every 2 to 4 hours. 

CARBAMIDE 

Description— Carbamide (urea) powder. 

Indications — As a diuretic in cardiac edema, incontinence of urine in children, ex- 
ternally to stimulate granulation tissue. 

Administration — V4 to 1/2 teaspoonful in 72 glass of water once or twice a day. A 
2% solution for external application. 

CARCHOUN 

Manufacturer — Merck Sharp & Dohme, Division of Merck & Co. Ltd., Montreal. 
Description — Carbachol, carbamylcholine chloride, powder. 
Indications — The reduction of intraocular tension in glaucoma simplex. 
Administration — One drop of a 1.5% solution to be instilled into the eye at 8 and 
12 hour intervals. 

CARDILATE 

Manufacturer — Burroughs Wellcome <S Co. (Canada) Ltd., Montreal. 

Description — Each scored tablet contains 15 mg. of erythrol tetranitrate. 

Indications — For the prophylatic and long-term treatment of patients with frequent 
or recurrent anginal pain. 

Administration — One tablet sublingually or in the buccal pouch 3 times daily, after 
meals. For those who are subject to nocturnal angina, an additional tablet about 1 hour 
before bedtime is recommended. 

Precautions — Caution should be observed in patients with cerebral hemorrhage or 
glaucoma. Even though the administration of Cardilate tablets permits more normal 
activity, patients should not be allowed to interpret freedom from attacks as a signal 
to drop all restrictions. 

CHILDREN'S HYOTHEN 

Manufacturer — Charles E. Frosst & Co., Montreal. 

Description — Each tablet contains: Chlorothen citrate 12.5 mg., hyoscine hydro- 
bromide 0.06 mg. 

Indication — For prevention or relief of motion sickness in children. 

Administration — 4 to 9 years of age, 1 tablet before starting a trip followed by I 
every 4 to 6 hours; 9 to 14 years, 1 or 2 tablets before starting the trip followed by 1 
or 2 every 4 to 6 hours. Should not be administered to children under 3 years of age. 

DULCOLAX 

Manufacturer — Geigy Pharmaceuticals, Montreal. 

Description — Bis (p-acetoxyphenyl)-2-pyridylmethane, a laxative acting in the colon 
only, upon contact with the mucosa. Non-toxic, well tolerated, clears bowel completely. 

Indications — Especially for complete bowel evacuation pre- and postoperatively. 
Useful in all types of constipation — atonic, spastic, dietary. Safe for senile and weak 
patients. Contraindicated only in acute surgical abdomen. 

Administration — Tablets: 1 to 3 at bedtime for a movement the following morning, 
or V2 hour before breakfast for a movement in 1 to 6 hours. For children 6 and over: 
1 tablet. 

Suppositories: One at a time when bowel movement required; for infants: V2 
suppository. 

6 THE CANADIAN NURSE 




SCHOOL for GRADUATE NURSES 

McGILL UNIVERSITY 



PROGRAM FOR GRADUATE NURSES LEADING TO THE 
DEGREE OF BACHELOR OF NURSING 

Two-year program for nurses with McGill Senior Matriculation or its equivalent. 
Three-year program for nurses with McGill Junior Matriculation or its equiva- 
lent. In the first year students may specialize in Public Health Nursing, Teach- 
ing of the Basic Sciences, or in Teaching and Supervision in one of the 
following clinical fields.- Medical-Surgical Nursing, Psychiatric Nursing, Mater- 
nal and Child Health Nursing. 

In the second year students elect to study in one of the following fields.- 
Nursing Education, Administration in Hospitals and Schools of Nursing, 
Administration in Public Health Nursing. 

PROGRAM FOR GRADUATE NURSES LEADING TO A DIPLOMA 

Students are granted a diploma on the completion of the first year of the 
degree program. All first-year students elect to study in a particular field as 
stated above. 

PROGRAM IN BASIC NURSING LEADING TO THE bEGREE OF 
BACHELOR OF SCIENCE IN NURSING 

Five-year program for high-school graduates who have passed in the required 
papers of the McGill Junior School Examination or their equivalents. This 
program combines academic and professional courses with supervised nursing 
experience in the McGill teaching hospitals and selected health agencies. 
This broad background of education, followed by graduate professional 
experience, prepares the nurses for advanced levels of service in hospitals 
and community. >, , 

For further informafion wriie to- 

DIRECTOR, McGILL SCHOOL FOR GRADUATE NURSES, 
1266 PINE AVE. W., MONTREAL, 25, QUEBEC. 



The ancient tend to ignore the fact tliat 
the years do not grow old as men grow old, 
but gatiier momentum as they multiply, 
bringing, with them new problems and new 
demands to press upon heart and mind. Age 
is not a synonym of wisdom ; experience is 
not a substitute for freshness of mind. The 
past can be useful but only to the extent that 
its lessons may help to prevent miscalcula- 
tion, and contribute to the needs of the 
present. History, which after all, is only 
human experience, is a warning and a guide. 
It is not a precept. — G. Herbert Lash 



CHILDREN'S HOSPITAL 
OF WASHINGTON, D. C. 

OFFERS 

Registered Nurses a 16-wk. supple- 
mentary program in pediatric nursing. 
Admission dates, May 6, September 1 , 
1959, January 5, May 3, August 30, 
1960. 

For comp/efe mformaiion write to: 

DIRECTOR OF NURSING, 
21 25-1 3th STREET, N.W., WASHINGTON 9, D.C. 



JANUARY, 1959 • Vol. 55, No. 1 



McMASTER UNIVERSITY 

School of Nursing 

1958-1959 

DEGREE COURSE IN BASIC NURSING (B.Sc.N.) 

A Four-Year Course designed to prepare students for all branches of 
community and hospital nursing practice and leading to the degree. 
Bachelor of Science in Nursing (B.Sc.N.). It includes studies in the human- 
ities, basic sciences and nursing. Bursaries, loans and scholarships are 
available. 

DEGREE COURSE IN SCIENCE TEACHING 
FOR GRADUATE NURSES (B.Ed.N.) 

A Two-Year Course designed to prepare graduate nurses to teach basic 
sciences in schools of nursing and leading to the degre, Bachelor of 
Education in Nursing (B.Ed.N.) It includes studies in the humanities, the 
physical, social and biological sciences, teaching and nursing education. 
Bursaries of Six Hundred Dollars each are offered in both years of this 
Course. 

For additional information, write to: 

School of Nursing, 
McMaster University, Hamilton, Ontario. 



COURSES 

FOR 

GRADUATE NURSES 

In various clinical fields, 
beginning March 9, June 1, 
August 24, and November 
16, 1959. 

Room, meals, and laundering 
of uniforms provided. 

Apply to: 

DIRECTOR, 

COOK COUNTY SCHOOL 

OF NURSING, 

DEPT. C, 1900 WEST POLK ST., 

CHICAGO 12, ILLINOIS 



QUEEN'S UNIVERSITY 
SCHOOL OF NURSING 

COURSES OFFERED 

Undergraduate 

Degree Course, 5 years leading to 
BNSc. Degree 

Graduate Nurses 

a. Degree Course, two years. 

b. Diploma Courses, one year. 
Public Health Nursing 

or 
Teaching and Supervision in Schools 
of Nursing. 

For i>ifoniuitto)t apply to: 

DIRECTOR 

SCHOOL OF NURSING, 

QUEEN'S UNIVERSITY 

KINGSTON, ONTARIO 



THE CANADIAN NURSE 



THE MOUNTAIN 
SANATORIUM 

HAMILTON, ONTARIO 

TWO-MONTH 

POSTGRADUATE COURSE 

IN THE IMMUNOLOGY, 

PREVENTION & TREATMENT 

OF TUBERCULOSIS 

This course is especially valuable 
to those contemplating Public 
Health, Industrial, or Tuberculo- 
sis Nursing. 

For further information apply to: 

Director of Nursing, 

Mountain Sanatorium 

Hamilton, Ontario. 



THE WINNIPEG GENERAL 
HOSPITAL 

Oflfers to qualified Registered Grad- 
uate Nurses the following oppor- 
tunities for advanced preparation : 

1. A six month Clinical Course in 
Obstetrics. 

2. A six month Clinical Course in 
Operating Room Principles and 
Advanced Practice. 

These courses commence in January 
and September of each year. Main- 
tenance is provided. A reasonable sti- 
pend is given after the first month. 
Enrolment is limited to a maximum of 
six students in each course. 

For further information please 

write to: 

DIRECTOR OF NURSING 

GENERAL HOSPITAL 
WINNIPEG, MANITOBA 



WILLS EYE HOSPITAL 
Philadelphia, Penna. 



The largest eye hospital in the 
United States, offers a six-month 
course in Nursing Care of the Eye to 
Graduates of Accredited Nursing 
Schools. Operating Room Training is 
scheduled in the course. 

• $180 PER MONTH & MAINTENANCE is 

provided for first four months. For the 
next two months compensation is $190 
& maintenance. 

• REGISTRATION FEE is $20 

• Course starts March 15 & Septem- 
ber 15. Ophthalmic Nurses in great 
demand for hospital eye departments, 
operating rooms & ophthalmologists' 
offices. 



For information zvrite to: 

Director of Nurses, 

Wills Eye Hospital, 

1601 Spring Garden Street, 

Philadelphia 30, Penna. 



A COURSE IN 

ADVANCED OPERATING ROOM 

TECHNIQUE AND 

MANAGEMENT 

is offered by 

THE MONTREAL 
GENERAL HOSPITAL 

to 

Qualified registered nurses. 

Classes of 6 months' duration 

are admitted Sepfember and March 

and are limited to 6 students. 

For further information write fo: 

THE DIRECTOR OF NURSING, 

THE MONTREAL GENERAL HOSPITAL, 

MONTREAL 25, QUE. 



JANUARY. 1959 • Vol. 55. No. 1 



DALHOUSIE UNIVERSITY 

School of Nursing 

COURSES OFFERED 

1 959 - 1 960 

1 . Degree Course in Basic Professional Nursing 

Candidates for the degree of Bachelor of Nursing are required to complete 
2 years of university work before entering the clinical field, and one year 
of university v/ork following the basic clinical period of 30 months. On 
completion of the course the student receives the Degree of Bachelor of 
Nursing and the Professional Diploma in either Teaching in Schools of 
Nursing or Public Health Nursing. 

2. Degree Course for Graduate Nurses 

Graduate nurses who wish to obtain the degree of Bachelor of Nursing are 
required to complete the three years of university work. 

3. Diploma Courses for Graduate Nurses 

(a) Public Health Nursing 

(b) Teaching in Schools of Nursing 

For further information apply fo: 

DIRECTOR, SCHOOL OF NURSING 
DALHOUSIE UNIVERSITY, HALIFAX, N.S. 



NOVA SCOTIA SANATORIUM 



KENTVILLE 



N.S. 



Offers to Graduate Nurses a Six- 
Month Course in Tuberculosis Nursing, 
including Immunology, Prevention, 
Medical & Surgical Treatment. 

1. Full series of lectures by Medical 
and Surgical staff. 

2. Demonstrations and Clinics. 

3. Experience in Thoracic Operating 
Room and Postoperative Unit. 

4. Full maintenance, salary & all staff 
privileges. 

5. Classes start May 1st and Novem- 
ber 1st. 



For information apply to: 

SUPT. OF NURSES, NOVA SCOTIA 
SANATORIUM, KENTVILLE, N.S. 



PSYCHIATRIC COURSE 

for 

REGISTERED NURSES 

The Nova Scotia Hospital offers to 
qualified Registered Nurses a six- 
month certificate course in Psychiatric 
Nursing. 

• Classes in March and September. 

• Remuneration. 

• Preference given to Nova Scotia 
applicants. 

For further information apply fo: 

Superintendent of Nurses 
Nova Scotia Hospital 
Drawer 350 
Dartmouth, Nova Scotia 



10 



THE CANADIAN NURSE 



ROYAL 
VICTORIA 
HOSPITAL 

SCHOOL Of NURSING 

MONTREAL, QUEBEC. 

Postgraduate Courses 

1. (a) Six month clinical course in Obstet- 
rical Nursing. 

Classes — September and February. 

(b) Two month clinical course in Gyneco- 
logical Nursing. 

Classes following the six month course 
in Obstetrical Nursing. 

(c) Eight week course in Care of the 
Premature Infant. 



2. Six month course in Operating Roor 
Technique and Management. 

Classes — September and March. 



3. Six month course in Theory and Practice 
in Psychiatric Nursing. 

Classes — September and March. 



Complete maintenance or living-out allow 
once is provided for the full course. 

Salary — a generous allowance for the 
last half of the course. 

Graduate nurses must be registered and in 
good standing in their own Provinces. 

For informafion and defails of the courses, 
apply to: — 

Miss H. M. Lamont, B.N. 

Director of Nursing, 

Royal Victoria Hospital, 

Montreal, P.Q. 



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JANUARY, 1959 • Vol. 55. No. 1 



11 



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12 



THE CANADIAN NURSE 



m cflfieoiflo nufist 

A MONTHLY JOURNAL FOR THE NURSES OF CANADA 
PUBLISHED BY THE CANADIAN NURSES' ASSOCIATION 



VOLUME 55 



NUMBER 1 



MONTREAL, JANUARY 1959 



The MeaHing of Faith 




AT OUR GENERAL MEETING in JunC, 
1958 it was my privilege to choose 
the watchword for this biennium and 
spontaneously I chose the word Faith. 
Now, as I try to analyze why I made 
this choice, I find the task rather 
difficult since faith is a composite 
of so many elements and the relevant 
importance of each one is difficult to 
assess. 

Was it belief in the great truths 
preserved for us and which form part 
of our heritage? Was it reliance on 
the intrinsic nature of ourselves ? Could 
it have been trust in our ability to 
meet the new, the strange, the challeng- 
ing situations which we encounter each 
day ? Was it, perhaps, confidence deriv- 
ed from the many accomplishments 
which have been linked together like 
the rings of a chain that was started 
away back in 1908? 

It could have been all of these — 
belief, trust and confidence — because 
each one is a part of what I saw in the 
meaning of Faith. Yes, we can have 
faith in our heritage, we of Canada, 
because ours is a countrv vast, varied 
and vital and in which there is so much 
space to grow. Our people, like our 



land, is varied and blessed with a 
multi-patterned cultural heritage, with 
two main streams, French and English 
in origin, flowing side by side down 
through the centuries. This is a rich 
past from which our own Canadian 
culture has been nourished. Though 




(G. Carpenter) 



Alice Girard 



JANUARY, 1959 • VoL 55. No. 1 



13 



differences between these two streams 
at times have seemed sharp, their 
hkenesses were greater than their dif- 
ferences as both bore the essential qua- 
lities of western European culture, 
making harmonious sharing between 
the two possible. 

As nurses, we have an old and 
growing heritage. Early, some of our 
women found a way to serve God and 
their fellowmen by caring for the sick 
and injured. The memory of devoted 
women like Jeanne Mance, working to 
relieve the suffering of the cruelly hurt 
and dying, inspires each of us as we 
seek to nurse the ill and promote the 
health of the individual. Today, Cana- 
dian nurses continue to build that 
heritage for the nurses of the future 
as both national groups hold in rever- 
ence the names of the admirable women 
who have inspired us in raising the 
standards of nursing care given to a 
rapidly expanding population, and im- 
proving the professional education of 
nurses and the health education of all 
Canadians. Our nurses are making 
a special contribution to nursing all 
over the world as they join with nurses 
of other countries to formulate and 
carry out the programs of international 
health organizations, and as our schools 
open their doors to students from 
countries where nursing education is 
not yet well developed. Our nursing 
heritage is both roots to nourish us 
and a torch to light the way. 

Though the past gives us values 
and ways of behaving that we can trust 
because they have been tested through 
time and found to be good through 
human experience, it is with the com- 
plex and often confusing situations 
of -the present that we must cope. It 
is here truly, in this diversity of today's 
problems, that faith is most needed and 
hardest to come bv. No small part 
of our difificulty in living with faith in 
the present arises from the fact that 
answers that have come down to us 
are no longer wholly satisfactory to 
answer the questions that arise today. 
Though many of us have been born 
and reared in homogeneous communi- 
ties where our parents and our schools 
told us not only what to do but quite 
frequently how to do it, very few of 
us reach maturity without living in 
heterogeneous communities where new 
acquaintances and friends do not con- 



form entirely to our pattern of living. 
Quite often the problems that confront 
us today are not to be solved by the 
solutions provided to any of us in our 
childhood. We are in a changing situa- 
tion that calls for imaginative and cre- 
ative living. From our past heritage 
we can bring only some of the values, 
some of the principles, and very few 
of the prescriptions of procedure. The 
rest we must acquire. This will be 
possible only if there is communication 
and understanding between peoples ; 
a willingness to accept the differences 
of others and to recognize that their 
beliefs and ways of behaving have 
validity for them. We in Canada un- 
derstand this for we have lived with 
heterogeneity of culture throughout our 
history. Professionally, we have also 
lived with diverse disciplines. With 
greater specialization and the utiliz- 
ation of more kinds of workers to do 
the job. increasingly we shall need 
faith in other people whose ways seem 
new and strange. We are utilizing 
teamwork and new techniques to speed 
up communication and understanding 
in nursing. Interesting examples of 
new approaches to old problems are 
being tried every day. One such ex- 
ample was brought to my attention 
recently when problems between in- 
ternes and nurses in an emergency 
department were worked out in one 
hospital through the means of a closed 
television circuit with cameras trained 
in the emergency room and with 
receiving screens in conference rooms. 
Needless, to say. this was successful 
only because skilled persons in the 
field of social dynamics and hiunan 
relations helped all those involved to 
understand what they saw and to seek 
solutions to the solvable aspects of the 
problems. The nurses and the internes, 
alike, found new potentials in their 
work and more satisfaction in the in- 
terpersonal relations with their co- 
workers. They took on some new- 
values; but they also had to rid them- 
selves of useless tradition to which they 
had frantically clung. 

One area of diversity that may 
be expected to arise with the demands 
for more and varied personnel to meet 
the nursing needs of Canadians is the 
kinds of nursing schools. We are in 
the midst of an evaluation study and 
we hope to go into an accreditation 



14 



THE CANADIAN NURSE 



program for which we are trying" to 
prepare nationally. These plans leave 
way for diversity and provide for the 
flexibility that will permit experi- 
mental programs aimed at meeting the 
rising needs. Agencies that employ 
nurses from the varying kinds of 
schools will also have to understand 
what each kind of worker has been pre- 
pared to do. Staff nurses as well as 
supervisors will need to understand 
the differences in the preparation of 
the various kinds of nursing personnel 
if the total nursing service is to be 
cooperatively coordinated and the needs 
of the patients adequately and efficient- 
ly met. 

Another challenging situation in 
nursing is that which is being brought 
about through government hospital in- 
surance. Here, also, our capacity to 
accept and adapt efficiently to new 
situation fraught with critical elements 
of change is being severely taxed. 
Many of us have already successfully 
tackled this problem and are ready 
to pass on to others the experience 
gained through this change. 

So in our complex diversified 
world, faith means having confidence 
in ourselves and in our ability to 
adapt to changing situations. It is 
also being able to have confidence in 
other people, to share their experiences 
and to trust in their willingness to help. 
It also means understanding of and 
respect for others. 

It is only a small step to believe in 
the future, when one has faith in 
what is being done today. If we can 
adapt to meet the changing situation 
of the immediate moment, we can adapt 
to meet the future. Adapting in this 
case often means to unlearn the old 
and to learn the new. To unlearn may 
be painful because what we have learn- 
ed is often precious to us ; because of 
the effort expended in the learning, 
because of the force of tradition and 
because of the satisfactions that we 
have had when we successfully used 
that knowledge in the past. But when 
knowledge is no longer satisfactory, 
nor relevant, perhaps even dangerous, 
we must discard it and expend the 
energy needed to seek other ways. 

Nurses, reared in tradition, have 
often found this difficult. Every nurse 
knows how difficult it is to help a pa- 
tient build self-confidence and inde- 



pendence by working out his own 
solutions for his problems or letting 
him make the necessary efforts to be- 
come self-sufficient when she feels that 
she could do all this for him far more 
expertly and derive much satisfaction 
out of doing it. However when these 
same nurses gain insight into the 
deleterious effects of their traditional 
methods they know they must effect 
a change of attitude and of goals in 
their work. 

Many nurse educators have yet to 
unlearn patterns of training and 
methods of teaching that prepared stu- 
dents solely for palliative and curative 
nursing. They must learn ways to pre- 
pare these future professional nurses 
for essential health promotion, illness 
and accident prevention, and rehabili- 
tative functions. Moreover, we all have 
much to learn about motivating a 
desire in both students and ourselves 
to seek out new truths through study 
and research and to apply them in the 
practice of nursing. Experimental pro- 
grams in nursing schools in Canada 
will provide some of the knowledge 
needed to improve nursing education, 
but the instructors will know that 
having the data is but the first step 
in the difficult art of producing a 
competent and efficient nurse with a 
mature mind and a heart that still re- 
sponds to the right stimuli. They as 
teachers must continuously search for 
better and more progressive methods of 
improving the education of students 
and therefore the nursing services to 
the sick. 

So it would seem that the watch- 
word "Faith" might well mean all 
these things : belief in those truths that 
form part of our heritage and that, 
held up against the bright light of 
today's reality, are found to be still 
valid ; reliance on ourselves, person- 
ally and professionally, secure in our 
own individuality among diversity all 
about us ; confidence in our adaptability 
to meet the new. facing its reality, 
imaginatively calling into pla}' relevant 
knowledge ; and courageously expend- 
ing the energy and emotion to discard 
what is no longer beneficial. Above 
all we must have faith in our mission 
which still remains the same in spite 
of the changing world in which we live. 
Alice Girard. President 
Canadian Nurses' Association 



JANUARY. 1959 • Vol. 55, No. 1 



15 



Squint or Strabismus 



Howard Rked. M.B., M.S., (Loxd.), F.R.C.S. (Exg. & C), F.A.C.S. 



SQUINT IS BY FAR the most impor- 
tant problem in ophthalmology be- 
cause about 3 per cent of all children 
suffer from this condition. Without 
treatment about one half of these be- 
come practically blind in one eye. All 
nurses should therefore have some 
knowledge of strabismus. 

Dkfixition 

A squint is any condition in which 
both eyes are not directed at the same 
object. A more exact but somewhat 
technical definition is that strabismus 
is any condition in which the \isual 
axes are not parallel. 

A mother will often consult a doctor 
because she thinks that her child is 
squinting. By this she means that he 
is half closing his eyelids. This is due 
to intolerance of bright light. It is true 
that many children with strabismus 
will close the deviating eye in a strong 
light. But this symptom does not 
always mean that strabismus is present. 

History 

The "'evil eye" of folklore and 
mythology undoubtedly referred to the 
condition of squint. The ancients did 
not understand that this was a physi- 
cal deformity. They attempted to ex- 
plain it as a visitation of the gods. It 
was a condition which had an un- 
pleasant appearance and it was often 
thought that people with it possessed 
evil or demoniac powers. 

As long ago as 400 B.C. Hippo- 
crates wrote about it and recognized 
that it occurred in families. Through- 
out the centuries no real advance was 
inade in the understanding or treat- 
ment of the condition until relative- 
ly recent times. A wandering quack, 
Chevalier Taylor, mentioned it in his 
writings and stated that he treated 
a convergent squint bv dividing the 
medial rectus muscle. In 1896, Javal, 



Dr. Reed is chief of the Department 
of Ophthalmology of the Winnipeg 
Clinic, Winnipeg, Man. 



a French ophthalmic surgeon, was the 
first to write a book upon the subject 
and lay down the principles which still 
form the basis of modern treatment. 

Cause 

1. Sex — Squints occur equally in 
both sexes. 

l.Heredity — There is a family 
history of strabismus in about 50 per 
cent of cases. 

3. Refractive errors — A high pro- 
portion of patients with the condition 
have high refractive errors, particularly 
hypermetropia and astigmatism. 

4. Trattiiia — This may occur at 
birth or as the result of an accident. 

(a) Birth: There is no doubt that a 
few cases of squint occur as a result of 
injury during birth. It is possible that 
excessive moulding of the head may give 
rise to sixth nerve palsy and w^eakness 
of the lateral rectus muscle, thus caus- 
ing a convergent squint. On occasion the 
application of forceps in a difficult 
delivery may injure one of the nerves 
or extraocular muscles and so cause 
a squint. 

(b) Accident: In adults, head injuries 
not infrequently damage nerves supply- 
ing the extraocular muscles and thus 
produce paralytic squints. 

5. Cerebral tumor — An intracran- 
ial tumor, particularly in the posterior 
cranial fossa, may give rise to raised 
intracranial pressure. This in turn 
damages the sixth nerve, causes weak- 
ness of the lateral recti, and leads to 
a convergent squint. These patients 
usually have headache and vomiting. 
Although such cases are not common 
all patients with squint should be 
examined at its onset to exclude the 
possibility of a tumor. 

6. Injections disease — There is no 
question that a squint may first be- 
come apparent after an infectious dis- 
ease such as measles, mumps, whoop- 
ing cough or scarlet fever. Inquiry 
will often reveal the fact that a relative 
has a squint and examination will show 
that the child has a high refractive 
error. In this case, the infectious dis- 



16 



THE CANADIAN NURSE 



ease has merely weakened the child's 
resistance so that the squint has appear- 
ed.' It might be said that the infectious 
disease was the trigger that fired the 
gun that was loaded by the refractive 
error and the hereditary tendency. 

Types of Squint 

Esotropia or Convergent Squint : 
The convergent squint is by far the 
most common form and occurs in about 
70 per cent of cases. 





Right esotropia or convergent squint 

Esotropia or Divergent Squint : This 
is a less common form of squint and 
occurs in about 30 per cent of patients. 

Hypertropia or Vertical Squint: In 
most of these cases a horizontal defect 
is associated with the vertical defect. 

All three of these squints may be 
further classified into three groups. 
They may be : 

1. Intermittent — in which the eye 
deviates only occasionally and appears to 
wander when the child is tired or day- 
dreaming. 

2. Constant — in which one eye turns 
constantly in, out, or up. It is this eye 
which tends to develop amblyopia. 

3. Alternating — this means that each 
eye may be used in turn and the vision 
in each eye is normal. In alternating 
convergent squints the right eye is used 
when looking to the left and the left eye 
is used when looking to the right. 

Development of \"ision 

The vision of infants is poor. It is 
probably 20/120 or less. Not until the 
age of six does vision improve to 20/ 
20. But the eye must be used for this 
development to occur. In a constant 
convergent squint, the convergent eye 
is never used and its vision does not 
develop. In fact, is seems that an active 
suppression takes place so that the 
vision in the eye actually deteriorates. 
If the eve is not used for some time, it 




Right extropia or clivcrgciit squint 

may become practically blind and in- 
capable of seeing more than move- 
ments. 

Treatment 

1. Inunediate: Only too often a child 
of about the age of nine or ten is 
brought into a doctor's office wnth 
a squint which has been present for 
many years. When the parents are 
asked why they have delayed bringing 
the child for treatment, thev reply that 
they were told that nothing could be 
done until the child was older, or to 
wait until he was older because time 
might cure it. These fallacies are still 
propagated not only over the garden 
fence but also in more enlightened 




Lejt hypertropia or vertical squint 

circles where the gravity of this condi- 
tion should be better understood. 

It is essential that treatinent should 
he undertaken as soon as a squint 
develops. If the child is very young 
it may not be possible to try to rectify 
the squint at once, but an examination 
should be made to exclude diseases of 
the retina, optic nerve, or lens which 
might be responsible for the squint. 

Treatment may be initiated in a child 
as young as ten months. Delay means 
that amblyopia will develop in a 
constant squint. If this is allowed to 
persist after the age of six the child 
is likely to be blind in the unused eye 
for the rest of its life. This is a serious 
matter. If the good eye should be acci- 
dentally damaged then the patient is fit 
onlv for a blind register. All who have 



JANUARY. 1959 • Vol. 55. No. 1 




Figure 1 



had the unhappy experience of register- 
ing such a patient as Wind, appreciate 
the importance of treating the child 
with a squint before the age of six 
when there is hope of restoring vision 
in the squinting eye. 

2. Cycloplcgia : It is important to 
use atropine or a similar drug to dilate 
the pupil. The retina must always be 
examined to exclude intraocular in- 
flammation, a congenital cataract or an 
abnormality of the optic nerve which 
may be responsible for defective sight 
and the development of a squint. When 
a child has a congenital anomaly of 
the squinting eye it may be impossible 
to improve the sight. In this case 
treatment must be modified. 

3. Refraction: If a child requires 
glasses in order to see clearly they 
must be provided. In aboilt 20 per 
cent of patients with a convergent 
squint the wearing of glasses for 
hypermetropia will result i.>^ a per- 
manent cure of the deviation. 

4. Patching : If the child has a 
constant squint and the vision of the 
squinting eye is defective, it is essential 
to patch the good eye to compel the 
child to use the lazv eye. An adhesive 
patch, put over this eye, is worn all 
day. every day. until the vision of the 
squinting eye is ecjual to that of the 
good eye. It is sometimes necessary 
to patch a fixing eye in this way for 
three or four months. The child should 
be seen at frequent intervals in order 
to check the im])rovement in vision. 
It is a great encouragement to the 
mother and to an intelligent child to 
realize that a few weeks of patching 
has resulted in the improvement of 
vision by one or more lines of type. 
It is often a good plan to advise the 
parents to allow the child to watch 



r.\'. or go to the movies with the eye 
patched. The constant movement on 
the screen and the child's interest 
in the program are perhaps the best 
stimuli to a lazy eve that can be devis- 
ed. 

5. Orthoptics: This valuable branch 
of ophthalmology has developed in the 
last quarter of a century although 
Javal enunciated the principles in 1896. 
Orthoptics deals with diagnosis of the 
state of the binocular vision and its 
training. Binocular vision is classified 
into three grades, and it is measured 
by means of an amblyoscope or similar 
instrument. Each eye looks down a 
separate tube at the end of which is 
placed an illuminated slide. (Fig. I) 

Grade I. This is the ability to see 
dissimilar objects with each eye and to 
be aware of both at the same time. 
Slides commonly used to diagnose 
grade I binocular vision are those in 
which one eye sees a parrot and the 
other eye a cage. 




Figure 2 
Fig. 2. The child is asked to swing 
the tubes and put the parrot in the 
cage. If he can do so without eitlier tlie 
parrot or the cage disappearing, grade 
I vision is present. 

Grade II. This is the ability to fuse 
similar images. Pictures used in this 



THE CANADIAN NURSE 



case are a rabbit without a tail before 
one eye whilst the other eye sees a 
rabbit without the bouquet of flowers. 




Figure 3 
Fig. 3. The patient with grade II 
vision will see a complete rabbit holding 
the bouquet. The absence of any part 
of the image will indicate the lack of 
grade II vision and will show which eye 
is being used. 

Grade III. This indicates stereo- 
scopic vision or the perception of depth 
and is the highest grade of binocular 
vision. No squint can be accounted 
completely cured unless grade III 
binocular vision is obtained. 

When the eyes have been made 
straight or nearly so by operation 
and the visual acuity is equal in each 
eye, orthoptic training is desirable 
to develop full binocular vision and 
normal ocular movements. Regular re- 
views at intervals are essential lest a 
relapse occur and further operations 
be required. All children with any 
tendency to squint should be kept 
under constant supervision up to the 
age of eight. If grade II or grade III 
binocular vision is ol)tained, relapse 
rarely occurs. 

6. Operation. If the wearing of 
glasses, patching, and orthoptics, fail 
to correct the angle of deviation, an 
operation must be performed. It is im- 
portant to warn parents that one 
cannot guarantee a perfect result in 
one operation. It is sometimes neces- 
sary to perform two or even three 
operations to straighten the eyes. It is 
unwise to attempt to correct a large 
deviation in one surgical procedure, 
because this may result in an over- 
correction. For example, a converg- 
ing eye may be made to diverge. Such 
an over-correction may be difficult to 
put right. 

Each eye has six mu.scles and all 
collaborate in each ocular movement. 
When the eye is looking in any given 



direction, only one muscle may be 
acting maximally but the other mus- 
cles are also in a state of tone, guiding 
and controlling the position of the eye 
to prevent it swaying off the desired 
direction. 

Parents are often afraid that an 
operation may damage the sight of 
the eye. Only the muscles are oper- 
ated on during a squint operation so 
there is no danger of this happening. 

There are two principles involved 
in all squint surgery : 

1. Overacting muscles are weakened. 

or 

2. Weak muscles are strenghtened. 
Overacting muscles are weakened 

by dividing their attachment to the 
eyeball and sewing the muscle to the 
eyeball a little further back. This 
lengthens the muscle so that it is 




Figure 4 
Fig. 4. If the eyes are capable of 
stereoscopic vision these two slides give 
the impression of looking into a bucket. 

relatively weaker. Muscles are streng- 
thened by cutting a small portion out 
of the muscle close to its attachment 
to the eyeball and resuturing the cut 
end of the muscle back to its previous 
attachment. This shortens the muscle 
by 5 or 6 millimetres and thereby in- 
creases its power of action. 

Nursing 

A generation ago children were 
kept in hospital for ten days follow- 
ing surgery, in many cases with both 
eyes bandaged. Since then the post- 
operative time in hospital has been 
decreasing. At present, most surgeons 
keep children in hospital for no longer 
than two or three days. 

No special preoperative care is 
required but the usual preanesthetic 
precautions are taken. When the child 
is anesthetized, the eyelashes are cut 
to half length. This is done to prevent 
them being cut during the operation and 



JANUARY. 1959 • Vol. 55. No. 1 



19 



falling into the wound. The scissors 
should be well greased so that the cut 
lashes stick to the grease and do not 
fall into the conjunctival sac. The face 
is cleaned with Zephiran and painted 
with the antiseptic of the surgeon's 
choice. 

The postoperative nursing is simple. 
Only the operated eye is covered with 
a pad and elastoplast. As soon as the 
child has recovered from the anes- 
thetic he is allowed to get up and 
play about the ward. He may even 
w^atch T.V. if it is available. Few- 
children attempt to remove the dress- 
ing and there is little or no danger of 
damage to the eye itself. Children do 
not rub the eye because it causes pain. 

The eye is uncovered one or two 
days after operation. Dark glasses may 
be worn for a few days if bright light 
bothers the child. An antibiotic oint- 
ment is instilled thrice daily for a few 
days. The conjunctiva is usually stitch- 
ed with fine catgut sutures which are 
absorbed or sloughed out in about a 
week. The eye is irritable until this 
happens, but as soon as the catgut has 
absorbed irritation practically ceases. 
The eye often remains red for several 
weeks or even months and parents 
must be warned of this to prevent 
anxiety. 



Surgery does not affect the vision 
of the eye. Thus, if glasses were need- 
ed before operation they must be worn 
after it. 

Prognosis 

What results may one expect from 
the treatment of strabismus? 

A complete cure has been achieved 
if the child has straight eyes, nor- 
mal sight in each eye, and binocular 
vision. The latter means that the two 
eyes are working together and the 
child has stereopsis. If seen early nearly 
50 per cent of children are cured. 

If there is delay in treatment the 
visual results are likely to be less 
successful. In all cases, however, the 
two eyes may be made to appear 
straight by operation so that a casual 
observer cannot tell that a squint has 
ever been present. 

References 

Reed, H., Strabismus — A Paediatric 
Problem. Analysis of 296 Cases. Canad. 
M.A.J., 11: 724, 1957. 

Lyle, T. K., Squint, London, Bailliere, 
Tindall & Cox, 1957. 

Scobee, R. G., The Oculorotatory 
Muscles, St. Louis, C.V. Mosby Com- 
pany, 1952. 



In the flood Old Days 

(The Canadian Nurse — January, 1919) 



The field of Public Health Nurses gets 
wider every year ; or perhaps it would be 
better to say the opportunities of that field 
are getting clearer to our eyes, and the call 
for nurses is great all over the country. 

* * * 

The Quebec Provincial Nurses' Associ- 
ation accepted with regret the resignation of 
the president. Miss Grace Fairley, who has 
accepted the position of superintendent of the 
General Hospital in Hamilton. 

* * * 

Listead of using gauze or cotton as a 
drain in the dressing of wounds, thin strips 
of blotting paper may be inserted ; for an 
external dressing, the blotting paper is 
first crumpled up in the hand. It makes a 



light, airy, inexpensive dressing, is easily 
removed, and is more readily destroyed than 

a cotton dressing. 

* * * 

It is stated that Cromwell died of in- 
fluenza. This Italian name for the disease 
was first used in England during the epi- 
demic of 1743. The first great epidemic of 
the disease in United States was in 1647, the 

most recent in 1890. 

* * * 

To cure hoarseness: Bake a lemon for 
twenty minutes in a moderate oven. Open 
one end and dig out the inside, then sweeten 
it with molasses. Repeat this in one hour. 
After one eats this the throat will be clear- 
ed as if bv magic. 



To know is nothing at all ; to imagine is everything. — .\n.atole France 
20 THE CANADIAN NURSE 



Gntraide An-Dela de la Frontiere 



Traitement de l'Insuffisaxce Aortique a l'aide d'une Valve en Plastioue 



Helen Creighton, A.M., J.D. ; Charles A. Hufnagel, M.D. 
JuANiTA Thorn, M.S.W. and Florence G. Presley, B.S., P.T. 



DURANT l'automne 1957, notre na- 
tion avait le plaisir d'accueillir, 
en meme temps que nos voisins cana- 
diens, la tres gracieuse reine Elizabeth 
d'Angleterre. D'interet un peu plus 
particulier pour celles d'entre nous qui 
sommes infirmieres, est le fait que 
I'Association des Infirmieres canadien- 
nes est sous le patronnage de Sa 
Majeste. 

Toutefois, si en effet nos deux pays 
participent quelquefois aux memes eve- 
nements sociaux et ont souvent les 
memes problemes, il est d'un interet 
encore plus frappant qu'un citoyen 
de la classe moyenne puisse beneficier 
de cette participation dans un tout 
autre domaine. L'histoire de Jacques, 
un canadien-frangais de dix-huit ans, 
qui s'est rendu jusqu'a I'hopital 
Georgetown pour le traitement d'une 
insuffisance aortique, demontre bien 
comment nous avons joint nos efforts 
aux votres pour trailer adequatement 
le cas d'un individu en particulier. Ce 
recit tiendra compte du patient du point 
de vue emotif et social, ainsi que de 
I'aspect medical et chirurgical. 

Insuffisance Aortique 

Par insuffisance aortique on signi- 



fie que d'elle-meme la valve de I'aorte 
est incapable d'empecher le retour du 
sang dans le ventricule gauche. La 
quantite de sang qui ainsi regurgite 
varie selon le degre d'impuissance de 
la valve. Les symptomes d'epuisement 
qui tot ou tard apparaissent, selon la 
gravite de la defectuosite mecanique, 
revelent une surcharge excessive s'ac- 
croissant continuellement et causant 
ainsi un effort exagere au myocarde. 
Toutefois, la modification d'une telle 
valve, en majeure partie ou complete- 
ment, offre a ces patients ainsi incom- 
modes, I'espoir et la perspective d'une 
vie plus normale. 

On trouve dans un cas d'insuffi- 
sance aortique les signes suivants : 

a. un pouls bondissant ; 

b. un souffle diastolique entendu au 
bord sternal gauche ; 

c. un bruit claque entendu en regard 
des gros vaisseaux de I'aine ; 

d. un souffle de "va et vient" si Ton 
deprime une artere au doigt ; 

e. dans les cas avances, un gros ven- 
tricule gauche decelable a la fluoroscopie. 

Ces patients ont une haute pres- 
sion arterielle systolique et une pres- 
sion diastolique anormalement basse. 
L'infirmiere doit se souvenir qu'afin 
d'obtenir une pression diastolique ade- 



Helen Creighton (A.M., Universite du 
Michigan ; J. D., Universite George 
Washington ; B.S.N., Universite George- 
town) est professeur adjoint a I'ecole 
des infirmieres de I'Universite George- 
town. Elle enseigne aux infirmieres les 
soins medicaux et chirurgicaux ; elle est 
aussi chargee de la surveillance des etu- 
diantes infirmieres, ainsi que de cours 
a ces dernieres a I'hopital de I'universite 
sur les maladies de la poitrine. 

Dr. Charles A. Hufnagel est profes- 
seur en chirurgie, professeur en recher- 
ches chirurgicales, et directeur du labo- 
ratoire experimental au Centre Medical 
de I'Universite Georgetown. II est bien 



connu pour ses recherches en chirurgie 
du coeur et il est le chef de I'equipe qui 
a mis au point la valve de plastique 
dont il est fait mention dans cet article. 

Juanita Thorn (M.S.W., Universite 
de Chicago) est directrice de la section 
s'occupant de I'etude des causes soumises 
(casework), Departement du Service 
Social, a I'hopital de I'Universite 
Georgetown. 

Florence G. Presley (B.S., College 
Arnold P.T., Universite Columbia) est 
a la tete de la section de Physiotherapie, 
Departement de Medicine Physique et 
Rehabilitation, a I'hopital de I'Universite 
Georgetown. 



JANUARY. 1959 • VoL 55, No. 1 



21 



quate, elle doit enregistrer le change- 
nient dans le son ainsi que sa dispari- 
tion. Par exemple, si chez tin tel pa- 
tient le premier son est entendu a 150 
et le premier changement apparait a 
30 et que le son descend graduelle- 
ment jusqu'a zero, la pression arterielle 
du patient devra etre enregistree 
comnie etant 150/30/0. De plus, on 
remarque que ces patients ont une pres- 
sion systolique beaucoup plus haute 
dans les arteres femorales que dans les 
brachiales. 

Les causes principales de ces dom- 
mages causes au coeur sont le rhuma- 
tisme articulaire aigu, I'endocardite et la 
syphilis. Parmi les nombreux groupes 
de patients qui ont ete, a une epoque 
ou une autre, sous observation dans 
notre centre medical, nous avons cons- 
tate que relativement, la plus grande 
majorite (a peu pres 80 pour cent) 
des patients souffrant purement d'in- 
suffisance aortique, ont a Porigine souf- 
fert de rhumatisme articulaire aigu.i 

Prothesr \'alvulaire de Plastique 

La prothese d'une simple valve de 
plastique ayant la forme d'une balle 
selon I'adaptation de I'un des auteurs 
(Dr. Hufnagel) est, de nos jours, la 
methode la plus efficace de corriger une 
insuffisance aortique. Cette valve est 
moulee tout d'une piece sans couture 
et doit etre extremement lisse et unie. 
Une telle valve de plastique est munie 
d'une soupape d'admission, d'un com- 
partiment contenant la balle et d'une 
voie d'ecoulement. Le compartiment 
est fabrique de fagon a permettre a la 
balle de se mouvoir en droite ligne 
du point oil elle repose jusqu'aux 
points d'arret de la valve. Une diffe- 
rence de pression du mercure de 5 
mm. produit soit I'ouverture ou la fer- 
meture complete de la valve. Sur la 
surface exterieure a chaque extremite 
de la valve il y a une rainure. L'aorte 
est maintenue en place a differents en- 
droits sur ces rainures a I'aide d'an- 
neaux. La valve est inseree dans I'arche 
descendante de l'aorte corrigeant ainsi 
la majeure partie de la regurgitation. 

1. Hufnagel, Charles A., Harvey, W. 
Proctor, Rabil, Pierre J. and McDermott, 
Thomas F. : "Surgical Correction of 
Aortic Insufficiency," Surgery, 35 :673- 
683 ri954). 



sans danger grave pour le patient. 

L'insertion de la prothese valvu- 
laire de plastique dans I'arche descen- 
dante de l'aorte, a pour effet de con- 
troler approximativement soixante- 
quinze pour cent de reflux. Le coeur 
se trouve ainsi debarrasse d'une ten- 
sion excessive. Les rayons-X demon- 
trent que le coeur diminue en dimen- 
sion. Le rendement du coeur s'ame- 
liore, la pression diastolique sous la 
valve devient normale et toute douleur 
disparait. 

Le Patient et sa Famille 

Par un bel apres-midi de septembre. 
Jacques, un jeune canadien-fran^ais de 
dix-huit ans, arrive a Washington, D. 
C. Souffrant d'une insufifisance de 
l'aorte a la suite d'une maladie de 
coeur dont il fut victime vers I'age de 
huit ans, son medecin de famille la 
d'abord dirige vers un medecin de 
Montreal et de la, vers notre centre 
medical a I'hopital Georgetown pour 
un traitement approprie. Le traitement 
de I'insufffsance aortique par Tinsertion 
d'une prothese valvulaire de plastique 
est bien connu a Montreal, nul doute 
grace a plusieurs annees d'etroite col- 
laboration dans la chirurgie du coeur 
d'un des auteurs (Dr. Hufnagel) avec 
un autre Canadien, feu le docteur 
Pierre J. Rabil autrefois de Montreal 
et plus tard professeur adjoint de 
chirurgie a Georgetown. 

Jacques arrive done depourvu de 
toute reference medicale adequate et 
meme bien entendu d'un dossier per- 
sonnel. Tout de meme, I'experience 
qu'a vecue le jeune Jacques demontre 
iusqu'a un certain point comment en 
face d'un probleme de sante serieux 
et mena<;ant, en depit de tout ce qui 
a ete ecrit au sujet du traitement 
complet d'un tel cas, certains facteurs 
humains du patient peuvent etre ne- 
gliges. 

Ainsi, tons sont legerement etonnes 
lors de I'arrivee de Jacques a notre 
centre medical. Si, en realite, conti- 
nuellement nous recevons des patients 
venant de centres assez eloignes de 
notre propre pays ainsi que de I'etran- 
ger, c'est bien la premiere fois que 
quelqu'un, souffrant d'une insuffisance 
grave de l'aorte, arrive afin de faire 
examiner son coeur en vue d'une in- 
tervention chirurgicale, apres un long 



22 



THE CANADIAN NURSE 



voyage continu de 27 heures en auto- 
bus! Un lourd paletot sur le bras en 
plus d'une petite valise, Jacques n'a 
jamais pense que fin de septembre a 
Washington pouvait etre synonyme de 
temperature moderement chaude. Tous 
sont un peu etonnes aussi qu'un pro- 
bleme reel puisse exister au sujet de 
la langue que park Jacques. Avec un 
degre d'instruction equivalant a une 
7ieme annee et une etude sommaire 
de I'anglais, Jacques s'est imagine que 
les medecins et les infirmieres a 
Washington etaient bilingues et qu'il 
pouvait tout simplement parler fran- 
qais. Pris au depourvu, le personnel 
de langue anglaise de I'hopital, habitue 
a rencontrer plutot les membres du 
corps medical canadien, parlant egale- 
ment les deux langues, doit imme- 
diatement avoir recours a quelqu'un 
pouvant parler le frangais. 

En entendant toute une variete'de 
franqais. un sourire amuse apparait 
sur les levres du pauvre visage fatigue 
et pale. La connaissance du franqais 
qui a tres bien fait I'afifaire d'un ancien 
professeur dans une clinique a la Sor- 
bonne, d'un ex-GI etudiant en mede- 
cine en Nonnandie, d'un Cajun en 
Louisiane et le franqais qu'une des in- 
firmieres a appris dans un high-school 
du Massachusetts — aux oreilles de 
Jacques aucun n'a I'accent du fran- 
qais qu'on parle a Quebec. Tout de 
meme, ce ralliement de jeunes a pour 
effet de creer un sentiment d'amitie 
et de curiosite de part et d'autre. 

Jacques est le troisieme d'une fa- 
mille catholique de huit enfants. Son 
pere, qui s'occupe d'habitude de la 
direction d'un hotel, etant malade n'a 
pu travailler durant I'ete precedent. Sa 
mere, ses cinq freres et ces deux soeurs 
jouissent relativement d'une bonne 
sante. A I'age de huit ans Jacques a 
soufifert de rhumatisme articulaire 
aigu avec polyarthritie. A 13 ans, il 
a eu une autre attaque de rhumatisme 
articulaire aigu et a 16 ans il fut hos- 
pitalise durant deux mois pour hyper- 
tension. Depuis. tous les jours il a 
pris une dose de digitalis, en plus de 
la pilule de penicilline qu'il prend jour- 
nellement depuis dix ans. Dans I'inter- 
valle, durant les deux dernieres annees. 
il a soufl:'ert de plus en plus de dyspnee 
et d'orthopnee. Durant I'annee qui a 
precede son admission ici, il a cons- 
tate un battement systolique dans son 




Jacques 

cou et sa tete, une transpiration anor- 
male et il s'est inquiete du fait que les 
palpitations de son coeur devenaient 
de plus en plus fortes. 

Sa 7ieme annee terminee, il a tra- 
vaille a la reparation des appareils 
de television, c'est-a-dire durant I'annee 
precedant son admission a I'hopital 
Georgetown. Apres avoir requ un pre- 
mier compte de $250 a la fin de sa pre- 
miere semaine a I'hopital, il s'est sou- 
dainement trouve en face de la realite. 
Ses parents n'ont jamais ete en faveur 
d'une operation pour lui, mais il a 
persiste dans son intention, disant "tcl 
que je suis dans le moment, je ne 
vaux absolument rien !" II est venu en 
autobus avec I'intention de payer lui- 
meme son passage. Afin de pouvoir 
payer I'operation qu'il espere subir, 
il a economise entre $250 et $300? 
Apres une semaine d'adaptation durant 
laquelle on fait revaluation de son 



"Jacques" est un pseudonyme et c'est 
volontairement que nous avons omis de 
mentionner le nom de I'endroit ou de- 
meure le patient. Tous les autres details 
sont exacts. Divers messages venant de 
Jacques nous apprennent qu'il a gagne 
16 livres, qu'il se sent physiquement 
bien, qu'il travaille a la reparation des 
appareils de television et qu'il jouit de 
la vie d'une faqon plus agreable. 



JANUARY. 1959 • Vol. 55. No. 1 



23 



coeur — line semaine de bonheur rem- 
plie d'espoir, (ses reves: il a une petite 
amie et il aime les enfants ; il a de 
I'ambition : il espere pouvoir gagner 
plus d'argent et il vent un jour avoir 
sa propre famille), imaginez sa conster- 
nation et son decouragement a la vue 
du compte ! 

On du avoir recours au Departement 
du Service Social afin d'aider a pre- 
parer I'arrivee de la mere de Jacques, 
ainsi que pour parer a divers besoins 
qui s'avcrent necessaires. 

En supposant qu'il aurait probable- 
ment ete plus facile pour Jacques d'ob- 
tenir de I'aide chez lui s'il y avait pense 
a I'avance et avait etabli son projel 
au prealable, et en tenant compte du 
fait que bien des caisses de secours 
ne sont a la disposition que des resi- 
dents de la ville, il faut maintenant 
trouver un moycn d'aider Jacques! Sa 
confiance naturelle dans les gens et une 
habilite indeniable pour communiquer 
avec eux ne pent nientir. Nous n'avons 
jamais doute un instant que le chirur- 
gien (Dr. Hufnagel) ferait I'oj^eration 
par amour de Dieu — mais les autres 
comptes? Par I'entremise du cbirur- 
gien en chef, il est possible de le traiter 
comme cas meritant observation et il 
peut ainsi obtenir une bourse du Hart- 
ford Family. Mis au courant du cas. 
le Metropolitan Heart Guild, un ser- 
vice benevole qui accepte quelquefois 
de rendre des services spcciaux, ac- 
cepte de payer les services d'une infir- 
miere privee ($16 pour huit heures) 
pour plusieurs jours apres I'operation 
ou tel que requis. Un autre service 
benevole semblable appele Aids to AU 
Charities s'offre a payer les frais de 
transport — un billet de premiere 
classe par avion jusqu'a Montreal, et 
cetera. 

La mere de Jacques emprunte I'ar- 
gent necessaire pour venir a Washing- 
ton, afin de passer deux semaines avec 
lui, juste avant et apres son operation. 
De nouveau, se basant sur les prix en 
cours dans son village, elle a tout bon- 
nement calcule depenser $10 par se- 
maine pour son logement. Quand la 
travailleuse sociale explique le cas a la 
proprietaire chez qui on a I'intention de 
loger la maman de Jacques, une bien- 
veillante juive d'origine russe qui a 
emigre dans ce pays il y a deja de 
nombreuses annees. non seulement ac- 
cepte-t-elle d'accueillir une voisine du 



Canada a un taux reduit, mais faisant 
preuve d'un sens parfait de I'hospita- 
lite, elle reconduit la mere de Jacques 
a I'autobus ainsi qu'a I'hopital. On ne 
peut s'empecher de remarquer aussi 
une profonde comprehension de part et 
d'autre et une sympathie reciproque 
qui semble s'etre naturellement deve- 
loppee en prenant le cafe ensemble, 
alors que la conversation, et en anglais 
et en frani^ais, ne peut certainement 
etre comprise que des inlerlocutrices 
elles-memes. 

SOINS ET PrEPARATIFS AVANT 

l'Operation 

Un patient qui doit subir une val- 
vuloplastie elective pour insuffisance 
aortique est d'habitude admis a I'ho- 
pital quatre jours ou plus avant la date 
de I'intervention. Cette periode durant 
laquelle le patient est sous observation 
permet de verifier I'absence de toute in- 
fection — un risque tres serieux dans 
une telle intervention chirurgicale — 
et permet aussi d'etudier le patient se 
basant sur certains precedes servant 
a diagnostiquer et a pronostiquer les 
chances du patient sur la table d'ope- 
ration. L'analyse d'urine de Jacques 
a montre 3 plus d'albumine avec 
cylindres hyalins. Hematocrite a 43; 
sedimentation a 3 ; formule blanche 
a 11.800 avec differenciel normal et 
tests serologiques negatifs. L'azotemie 
s'elevait a 12 mg %. La recherche 
des "C-rcactive-proteins" s'avera ne- 
gative et le titrage des anti-streptoly- 
sines s'est etabli a 1/160. A I'electrocar- 
diogramme, on trouve une hypertro- 
phic ventriculaire gauche et de fre- 
quentes extra-systoles. L'exaraen (luo- 
roscopique du thorax decele une aorte 
a pulsations exagerees tandis que I'oe- 
sophage n'est pas deplace. Avec deux 
cc. de Thiomerin (un diuretique), on 
obtient une perte de poids de deux 
livres et demie. A la suite de toutes ces 
decouvertes et de I'examen du patient 
par plusieurs medecins, on a pose le 
diagnostic d'insuffisance aortique et on 
a juge que Jact|ues profiterait d'une 
valvuloplastie aortique. 

On explique done a Jacques tons 
les examens et procedes afin qu'il 
comprenne bien le but de chacun. 
Ouoique dans un sens on ne puisse 
dire qu'un patient trouve agreables les 
examens destines a etablir un diagnos- 



24 



THE CANADIAN NURSE 



tic, d'une certaine facon Jacques est 
satisfait. On accomplit quelque chose 
et line telle activite est pour lui syno- 
nyme de progres. "Je suis venu ici pour 
guerir et on s'occupe de moi — un. 
deux, trois, etc . . ."" 

De plus, il aime bavarder avec les 
infirmieres, plus particulierenient avec 
les etudiantes: "De gentilles jeunes 
filles, elles me traitent comme un etu- 
diant d'universitc." Elles lui enseignent 
quelques mots supplementaires d'an- 
glais — plus particulierenient certains 
mots d'usage courant parmi les ecoliers 
americains, et lui leur apprend quel- 
ques mots de franqais. Les jeunes. 
quelle que soit leur langue. semblent 
s'accommoder facilement de sujets de 
conversation tels que les chansons popu- 
laires, la danse. le cinema, les pages 
illustrees et les sports. Un gar^on 
timide et bizarre a son arri\ee. Jacques 
s'epanouit rapidement et de\"ient un 
jeune homme important et plein d'as- 
surance. Ses compagnons de chambre 
et leurs visiteurs partagent avec lui 
magazines, fruits, fleurs et television. 

A des intervalles irreguliers. il est 
soumis a un regime experimental 
pauvre en sel. Ceci meme il trouve 
agreable — en partie parce qu'il I'ac- 
cepte comme un moyen d'obtenir une 
meilleure sante et d'autre part parce 
qu'une marque d'attention a son egard 
lui est d'un reconfort moral. Pour 
Jacques, de manger des mets pauvres 
en sel et qu'on lui dise qu'il est "un 
brave type," cela vaut la peine. "Meme 
si j'en ai besoin, je puis bien ne pas 
les manger ; ce n'est pas pour qu'on mc 
dise que je suis un brave type • — nous 
echangeons et tout le moncle est con- 
tent." 

L'arrivee de sa mere augmente sa 
joie et sa confiance ; il est fier de la 
presenter a tous et chacun et lui sert 
d'interprete quand elle en a besoin. Le 
fait qu'elle ne veuille employer aucun 
mot anglais, comme par example 
"okay" ou "hello" amuse Jacques par- 
dessus tout et il ajoute avec une etin- 
celle dans les yeux "Une vraie fran- 
caise. elle ne parle pas anglais — pas 
un mot !" Apres un moment, il aioute 
"Moi. ie suis francais aussi. mais un 
Canadien-francais moderne." 

Au cours de la journee qui a pre- 
cede I'operation. on a determine le 
groupe saponin de Jacnues et fait la 
compatibilite. lui procurant 2000 cc. de 



sang. On a institue : quinidine chaque 
jour ; et quatre fois par jour, penicilline 
en aerosol (2 cc. -50,000 unites au cc), 
associe a Tergemist. Avant une telle 
operation, comme patient catholique et 
comme c'est I'habitude, il se fait benir. 
Apparemment, I'oncle prefere de Jac- 
ques est un seminariste et toute visite 
d'un pretre, ou d'une religieuse, et 
toute pratique religieuse, comme par 
exemple la Sainte Communion ou une 
simple benediction, semble lui etre d'un 
grand reconfort et lui donner du cou- 
rage. II demande et obtient la permis- 
sion de conserver son scapulaire sur 
lui durant la duree de I'intervention 
et dans son lit il garde un chapelet et 
un crucifix. 

SOINS ET TrAITEMENTS APRES 

l'Operation 

Apres I'operation de Jacc|ues, sa 
pression arterielle, son pouls (apical 
et radial) et sa respiration sont veri- 
fies tous les quarts d'heure pendant 
deux heures et ensuite toutes les demi- 
heures jusqu'a ce que tout se soit stabi- 
lise (deux heures plus tard), puis 
chaque heure durant les premieres 24 
heures. Etant donne qu'on avait insti- 
tue le drainage sous niveau liquidien, 
I'infirmiere doit enregistrer frequem- 
ment la quantite et la qualite de I'ecou- 
lement ainsi que les fluctuations dans 
le tube en varre. Durant deux jours on 
le garde sous une tente d'oxygene avec 
Tergemist tout en administrant un glu- 
cose a 5 pour cent en permanence, a 
debit lent. Apres I'intervention, on con- 
tinue digitoxine et quinidine ; on ad- 
ministre erythromycine et/ou chloro- 
mycetine de faqon prophylactique ; 
methadon contre douleurs et aspirine 
X gr. si la temperature s'eleve a plus 
de 101 °F. Les jambes de Jacques 
sont enveloppees dans des bandages 
Ace et on lui recommande de les bou- 
ger ainsi que de tousser. et de faire, 
chaque heure, des exercices profonds 
de respiration. Au besoin. on se sert 
de succion afin d'empecher Jacques 
d'avaler des secretions durant les deux 
])remiers jours. 

Le jour de I'operation a huit heures 
du soir, on fait un hematocrite. Jac- 
fiues a recu trois chopines de sang 
durant I'operation. Ouotidiennement. 
pendant quatre jours apres I'operation 
on fait une formule sanguine complete. 



JANUARY, 1959 • Vol. 55, No. 1 



25 



un hematocrite et une analyse d'urine. 
On se sert d'un rayon-X portatif pour 
verifier de nouveau I'expansion pulmo- 
naire, de meme que pour s'assurer s'il 
ne se produit pas d'epanchement tho- 
racique. 

Le premier jour apres son opera- 
tion, Jacques re(;oit une solution intra- 
veineuse de glucose. Le jour suivant il 
commence a prendre des liquides : the 
chaud et coca-cola d'abord et qu'il 
conserve ; on en augmente la quantite 
graduellement. Des le troisieme jour, 
Jacques est au regime liquide complet. 
Ensuite, comme il digere bien la nour- 
riture, on lui permet de consommer 
800 mg. d'une diete molle sans sel ou 
bien 800 mg. d'un regime normal sans 
sel, comme il le prefere. Comme la 
diete molle contient un plus grand 
choix de mets qu'il prefere, Jacques 
choisit celle-ci de preference, pour une 
semaine. 

La temperature de Jacques demeure 
a 101 °F durant plusieurs jours apres 
I'operation, meme si les hemocultures 
sont negatives. On note une paralysie 
partielle dans son bras et sa jambe 
gauche. Craignant la possibilite d'une 
rupture vasculaire cerebrale, on insti- 
tue la therapie a I'heparine. La patient 
recouvre I'usage complet de son bras 
et de sa jambe gauche deux semaines 
plus tard. Une etude neurologique 
complete nous porte a croire que cet 
etat passager a du etre cause par des 
phenomenes de compression durant 
I'intervention. 

Apres une thoracotomie posterolo- 
laterale gauche, le Departement de 
Medecine Physique et Rehabilitation 
evalue le patient. Ce programme de re- 
habilitation a pour but d'ameliorer I'a- 
lignement vertebral, de retablir le 
rythme des mouvements scapulohume- 
raux et la capacite respiratoire. Les 
mouvements auxquels on soumet le pa- 
tient sont les suivants : 

1. Flexion complete de I'epaule. 

2. Abduction du bras a 90°, coude 
flechi a angle droit, suivie d'une rota- 
tion interne et externe complete. 

3. Palpation des epineuses avec le 
pouce. 

4. Position horizontale sur le dos, 
mains reunies derriere le cou. 

5. Exercices de respiration. 

Tous ces exercices sont accomplis a 

la limite de la douleur et de la fatigue. 

A mesure que I'etat general du pa- 



tient sameliore, on commence des exer- 
cices physiques et on accroit ceux-ci 
progressivement jusqu'a ce que le sujet 
soit juge capable de participer aux ac- 
tivites plus dirigees du departement 
de physiotherapie. On le soumet aussi 
aux tests pre-emploi. Les informations 
obtenues feront partie de son dossier 
et faciliteront le travail des moniteurs 
de tout autre departement de physio- 
therapie et de rehabilitation du Quebec 
destine a rendre le retour au travail 
de notre patient possible. 

Au debut Jacques montre peu d'en- 
thousiasme pour ces exercices; il veut 
"attendre quand je serai mieux" et ne 
semble pas realiser que cette therapie 
fait partie integrale du processus. Ce- 
pendant. un certain jour apres les 
soins du matin suivis d'un repos d'une 
heure, on ouvre la radio a une emission 
de musique populaire avant de com- 
mencer la periode d'exercices. Cette 
musique. en plus de la gaiete communi- 
cative du jeune therapiste, reussit a 
convaincre Jacques et a obtenir sa co- 
operation. Une fois le programme en 
cours, les nombreux compliments que 
ses succes lui attirent, reussissent a 
vaincre toute autre resistance de sa 
part. Si le desavantage physique dans 
lequel son coeur I'a place ne semble 
pas I'avoir prive d'afifection et d'egards. 
d'un autre cote il n'eprouve pas la sa- 
tisfaction d'etre considere comme un 
homme. mais plutot comme un "bon 
enfant." Ainsi le programme de re- 
habilitation a un double but, physique 
et psychologique a la fois. 

Parmi les differentes coutumes qu'on 
lui enseigne. la necessite d'avoir une 
prophylaxie dentaire lui est particu- 
lierement soulignee. Bien qu'il ait 
d'autres habitudes d'hygiene person- 
nelle solides et bien formees, le soin 
de ses dents semble avoir ete neglige. 
En effet, il a plusieurs dents cariees. 
ne lui faisant toutefois pas mal, qu'il 
neglige de faire reparer et meme de 
brosser. 

Jacques, d'une nature gregaire. se 
plait dans la compagnie des gens en 
general et ne semble jamais s'en fati- 
guer. Que ce soit une infirmicre. un 
medecin, un autre patient ou un parfait 
etranger. Jacques adore bavarder avec 
eux, quel que soit le sujet de conversa- 
tion. A plusieurs reprises il prolone^e 
meme la conversation jusnu'a ce qu'il 
ait appris ce qu'un Jamaicain a I'in- 



26 



THE CANADIAN NUR.SE 



tention de faire a son retour chez lui, 
apres I'obtention d'une niaitrise en 
chimie ; comment une dame d'age 
moyen confectionne au crochet un nap- 
peron dont le motif a la forme d'un 
ananas ; et comment un fermier du 
Maryland s'y prend pour ecorcer le 
tabac avant de le faire secher. Cette 
facilite avec laquelle il communique 
avec ses semblables lui attire de nom- 
breux amis. 

Durant sa derniere semaine a I'ho- 
pital on permet a Jacques de sortir 
pour diner, ainsi que de courtes visites 
aux divers endroits historiques. Comme 
il re<^oit de nombreuse invitations, 
bientot la Maison Blanche, le Capitol, 
Lee Mansion, "Embassy Row," le 
Musee d'Art national, sont autant 
d'endroits qu'il a deja visites. Sa 
dyspnee a disparue, son coeur ne 
"frappe" plus aussi fort, il reprend 
ses forces graduellement et gagne len- 
tement quelques onces de bonne chair. 

Rktour Chez lui 

Cinq semaines et demie sont vite 
ecoulees. Un matin du debut de novem-' 
bre. par une temperature agreable, des 
amis reconduisent Jacques a I'aeroport. 
Apres un echange de poignees de 
mains et de salutations il monte a bord 
de I'enorme avion argente qui I'ame- 
nera vers Montreal. 



De nos jours il est difficile de suivre 
le progres rapide accompli dans le do- 
maine des decouvertes. C'est pour 
chacun d'entre nous un devoir impe- 
rieux de partager avec autrui les bien- 
faits qui resultent de ces decouvertes, 
Cela demande des patients trcs coura- 
geux et le genereux appui des equipes 
medicales, afin de permettre a chacun 
d'entre nous de faire face a I'avenir 
avec confiance. Alors que Jacques dis- 
paraissait dans le ciel clair en direc- 
tion du nord, cet extrait de "Saluta- 
tion du Crepuscule" nous est venu a 
la memoire : 

Ecoute 1 'exhortation que t'offre le cre- 
puscule 

.\ie confiance dans ce jour 
Car il est la vie, la vraie vie de vie, 
Dans son cours abrege reposent toutes 
les verites et 
Realites de ton existence : 
L'enchantement de grandir 
La gloire dans Taction 
La splendeur de la beaute. 
Car hier n'est qu'un reve, 
Et demain qu'une vision ; 
Mais de bien vivre aujourd'hui fait 
D'hier un reve de bonheur, 
Et de tons les demains une vision 
d'espoir. 

.\ie confiance dans ce jour ! 
Tel est la salutation qu'offre le crepus- 
cule ! 



.\ liearing loss to one member invariably 
involves the whole family. Misunderstandings 
arise, words are missed, repetition is fre- 
quent, irritation on both sides results and 
it is here that one should remember that an 
understanding of the other fellow's situation 
should be taken into consideration. No one 
wants to become irritated, but it is diffi- 
cult to avoid, on the part of both parties, 
unless there is a desire to understand the 
frustration by the one who wants to be heard 
as well as the one who wants to hear. 

The other members of the family can be 
very lielpful to the suflferer. He will make 
mistakes. Don't laugh at but with him. No 
special consideration should be given so far 
as his obligation to the group is concerned. 
He would resent this. E.xpect him to carry 
on as before, he can stand on his own feet. 
Let him work out his problems in his own 
way. But if he pretends to hear, when you 
know he doesn't, let him know at once. 



Bluffing is bad. When he is present, always 
include him in the conversation — don't talk 
past him. 

There are adjustments that must be made, 
certainly, but his position is one that can 
be just as full of successful attainment as 
before. Former activities should be, as far 
as possible, maintained. There is no point 
at all in withdrawing to the point of per- 
petual loneliness. A little extra courage, 
a bit more determination to use to the full 
what he has left, goes far to keep up that 
morale which is bound to maintain the proper 
frame of mind to carry him through to 
successful accomplishment. Many of the most 
successful people in the business, professional 
and every other field, have, for years, carried 
with them a severe hearing loss. Diffi- 
culties, yes, but the determination to succeed 
was uppermost and left no room for negative 
thinking. The frame of mind will determine 
the degree of success. — The Hearing Eye 



JANUARY. 1959 • Vol. 55, No. 1 



ar 



The Pediatric Irse and Play Therapy 



Patricia A. Pixkertox 

FOR CHiLDREX, play is an essential 
part of growing up, of achieving 
physical and emotional maturity. It is 
the most important way in which the 
child can explore the world, test new 
skills and abilities, try new things, 
make new friends, learn to balance 
his desires and capabilities and relieve 
tensions. 

There are many kinds of play : 
exploratory, dramatic, constructive and 
creative. A child may (and should) 
play alone, with other children of 
varying ages and with adults. Play 
with others provides opportunities for 
mental, social, physical and emotional 
growth. 

Through play a child learns skills 
and gains self-confidence, as well as 
knowledge. He learns to adjust his 
wishes for group benefit, to conform 
to group-imposed and self-imposed 
rules (besides helping to formulate 
them), to depend upon emotional satis- 
factions that come from relations with 
contemporaries. He begins to adapt 
himself to the world outside his fami- 
ly circle, to discover in his own way 
the meaning of life as it applies to him. 

The school-aged child is learning 
to become a self-directed individual.. 
He feels a need to control himself. 
Instinctively, he is trying to master 
his fears, and satisfactorily integrate 
his aggressive and sexual drives into 
his complete personality. He becomes 
a gregarious person who appreciates 
the rights and individuality of others. 
He develops desirable habits of associ- 
ation, and the all-important ability to 
be a friend. 

Older children need opportunities 
to continue their school work and 
learn to take responsibility in pro- 
portion to their age. 

The need for play is present in 
all children. A sick or handicapped 
child needs suitable play opportunities 



Miss Pinkerton was a third year 
student in the degree program of the 
University of Saskatchewan School of 
Nursing when this material was pre- 
pared. 



more than he ever did when he was 
well. It is essential to adopt recreation 
to his abilities and thus fill his needs. 

It is as important for the nurse 
to see that her patients are occupied 
constructively as it for her to pro- 
vide them with medications, nourish- 
ment and treatments. Providing play 
activities tells the child that his needs 
are understood completely. 

Acutely ill or permanently handi- 
capped children especially need the 
outlets and benefits play provides. 
Careful thought should be given to 
individual abilities and needs. Ideally, 
some form of recreation should be pro- 
vided for each child, even if the nurse 
must rack brains, books and supplies 
for appropriate ideas. 

A very sick child, because of the 
attentions he receives, develops strong 
feelings of dependency and a definite 
attraction to the dependent state. 
During convalescence he requires guid- 
ed play experience to help him regain 
independence and meet the realities of 
life. Without this, regression is almost 
inevitable and will be much more diffi- 
cult to deal with in the reality than in 
the threat. 

A child loves to help the nurses and 
the good this does his self-confidence 
more than ofTsets the time and trouble 
it costs her in providing the opportuni- 
ties for him. 

Meal hours aflford a valuable op- 
portunity to provide a home-like, social 
experience which keeps the child close- 
ly in touch with reality. Their pos- 
sibilities must not be neglected. 

A child reveals his thoughts and 
feelings in the way he plays. Care- 
ful observation can provide knowledge 
as to their degree of adjustment to 
hospitalization. By understanding their 
actions, the nurse can greatly improve 
stafif-patient relationships by helping 
her appreciate the children as indivi- 
duals. She will be more successful_ in 
meeting their needs, thus also deriving 
greater satisfaction from her pediatric 
nursing. 

The nurse encourages her patients' 
interests when she provides them with 



28 



THE CANADIAN NURSE 



play materials, which should be se- 
lected to provide further learning, and 
opportunities for self-expression. Play 
materials should be suitable to the 
child's age and level of illness. Besides 
being appealing to the imagination, 
more difficult activities should be en- 
couraged to stimulate new skills. 
Varied toys that have a safe finish 
and rounded edges for individual and 
group play should be selected. 

The child's play should be super- 
vised, being careful not to take the 
initiative from him. Emphasis should 
be placed on what he should be able 
to do. Teach the child the use of tools 
and materials and the places they can 
be used, but allow him to express him- 
self in his own way. Stereotyped acti- 
vities are of little benefit. Remember 
that a positive approach encourages 
confidence but that a negative one 
threatens it and destroys initiative. 

Hard physical play, while using 



a minimum of supplied material, dis- 
courages the accumulation of frustra- 
tions. It is the main way in which 
a child learns to master his feelings 
through the use of socially accepted 
outlets. 

A hospital play program is health 
giving, is essential for all types of 
growth, prevents regression and aids 
in restoring the child to normal health 
besides helping him keep pace with 
his peers. Through play, with adequate 
suitable supervision, a child is helped 
to mould a wholesome personality and 
the character traits so important for 
a happy, successful life. 

References 

— Jeans, Wright, Blake — Essentials of 
Pediatrics 

— Play and Playmates — booklet pub- 
lished by the Mental Health Division of 
the Department of National Health and 
Welfare. 



3n iHemoriam 



Margaret Annie (Dov/sley) Austin 

who graduated in 1913 form Toronto General 
Hospital died on August 5, 1958 after a long 
illness. 

* * * 

A. Margaret Collie, a graduate of the 
Victoria General Hospital, Halifax died on 
September 15, 1958. She had lived in New 
York and practised her profession there for 
most of her life. 

* * * 

Grace Victoria (MacDonald) Cooke 

who graduated form Toronto General Hospi- 
tal in 1943 died suddenly on July 1, 1958. 

* * * 

Doris (Howden) Counter, a graduate of 
Toronto General Hospital in 1934 died on 
September 8, 1958. 

* * * 

Sarah (Reid) Driver who graduated 
from Toronto General Hospital in 1913 died 
on August 22, 1958 after a long illness. 

Jean Inglehart a graduate of Brantford 
General Hospital in 1924 died suddenly on 



September 23, 1958. She had been on the 

staff of the hospital for 20 years. 

* * * 

Willa Jean Martin, a graduate of 
Yarmouth Hospital, N.S. in 1939 died on 
October 13, 1958 after a long illness. She had 
been a member of the Roseway Hospital 

staff, Shelburne, N.S. 

* * * 

Viva (Thompson) Mason who graduat- 
ed from Royal Victoria Hospital, Montreal 
in 1913 died on October 22, 1958. 

* * * 

Teresa (Cahill) Olsen, a graduate of 
St. Paul's Hospital, Vancouver in 1950 died 
recently after an illness of several months. 

* * * 

Louise (Manchester) Swan who gradu- 
ated from Toronto General Hospital in 1920 

died during the summer of 1958. 

* * * 

Everetta (Sally) Watters a graduate 

of Montreal General Hospital in 1910 died 
on October 18. 1958. She held the rank of 
lieutenant nursing sister. R.C.A.M.C. 



Pray you now, forget and forgive. 

— Wm. Sh.^kespeare 



I tell you the past is a bucket of ashes. 
— Carl Sandburg 



JANUARY. 1959 • Vol. 55. No. 1 



29 



RESEflRCH 



The Master Plan of Rotation 



Margaret M. Street, B.A. 

A MAJOR ADVANCE in modern nursing 
education is the increasing recogni- 
tion being given to the importance 
of the student's clinical experience 
in the educational program. As an 
integral part of the curriculum, it 
must be planned with the same thought 
and care as are the formal classes. 
in accordance with sound principles 
of professional education. The master 
plan of rotation is a useful tool in 
such planning. Basic to the success 
of the master plan are two major con- 
cepts : 

1. Designing and administering the 
master plan is the function of the 
faculty of the school of nursing. 

2. Once designed, the master plan 
may not be modified to meet service 
demands of the hospital, that is, students 
may not be moved from clinical areas to 
which they have been assigned for ex- 
perience, in order to meet nursing serv- 
ice demands in other areas. The master 
plan may be modified for educational 
reasons, as necessitated by circumstances 
affecting the individual student, for ex- 
ample, sickness. 

After six years of experience in 
using the master plan of rotation, the 
faculty of the Calgary General Hospi- 
tal School of Nursing believes that 
this method of pre-planning the stu- 
dents' educational program is sound 
and practical. This is not to say that 
there are no problems in its construc- 
tion and administration, but these are 
minimal in comparison with the bene- 
fits derived from its use. 



Miss Street is .Associate Director of 
Nursing of the Calgary General Hospital 
School of Nursing. , 



Basic Factors to be Considered 

1. The Curriculum of the School of 
Nursing : 

a. The philosophy of the school. 

b. The aims of the educational pro- 
gram, and the kinds and amounts 
of learning experiences necessary to 
achieve the aims. 

c. Regulations governing schools of 
nursing in the province, e.g., legal 
requirements specifying certain clinical 
experiences as prerequisites for regis- 
tration. 

d. Insofar as it is possible to consi- 
der these, the requirements for regis- 
tration of other pro^'inces, states, or 
countries. 

e. Requirements for accreditation — - 
if and when an accreditation program 
is established for schools of nursing 
in Canada. 

f. The pattern of the educational 
program, as planned by the faculty for 
each class. 

2. The nature of the learner : The 
following factors should be considered, 
in relation to designing the rotation 
plan for the individual student : 

a. Her background, as far as possible 
and practicable : general education, social 
influences — family, community, church. 

b. Intelligence level. 

c. Age level and degree of maturity. 

d. Adaptability: adjustment to the 
school of nursing, to communal living, 
to the clinical situation. 

e. Readiness for certain experiences 
at a given time, for example, operating 
room. 

f. Her aims, needs and motivation. 

g. Problems — physical, psychological, 
social, or other. 



30 



THE CANADIAN NURSE 



The Nature of the Learning Process 
and Principles of Learning: It is de- 
sirable in constructing the master plan 
of rotation to be mindful of both the 
principles of- learning and the nature 
of the learning process. 

a. Learning is manifested by changes 
in behavior; changes in behavior result- 
ing from experience rather than merely 
from the process of maturation are 
the essence of learning; and a student 
has not really learned unless the changes 
in behavior persist. 

b. Learning takes place more effective- 
ly when a student is ready to learn. 
Both psychological and physiological 
readiness are important. Thus, certain 
students may be ready for the operat- 
ing room earlier than others in the 
same class. 

c. Individual differences must be con- 
sidered. 

d. Motivation is essential for learning, 

e. What the student learns in any 
given situation depends upon what she 
perceives. A student learns what she 
actually uses. 

f. Learning takes place more effective- 
ly in a situation where the student 
derives feelings of satisfaction. 

g. Recognition of similarities and dis- 
similarities between the past experience 
and the present situation facilitates the 
transfer of learning. 

h. Interpersonal relationships are im- 
portant in motivation and determining 
the kind of social, emotional and intel- 
lectual behavior which emerges from the 
learning situation. 

i. Evaluation by both the student and 
the teacher is essential to determine 
whether desirable changes in behavior 
are taking place. 

It will be noted, by a thoughtful 
examination of the above principles, 
as stated by Ole Sand, that they con- 
tain many indications as to the place- 
ment of experiences for individual stu- 
dents, and the guiding of the learning 
process in the clinical areas to which 
she is assigned. 

4. Criteria for a zvell organized cur- 
riculum : In planning the students' 
clinical experience, the criteria for 
a well organized curriculum are also 
to be borne in mind. These have been 



Sand, Ole. Curriculum Study in Basic 
Nursing Education, New York, 1955, 
G. P. Putnam's Sons. 



stated in the same source noted above : 
Continuity: — Reiteration of major 
curriculum elements which can serve 
as threads running from the first year 
to the last, to tie the learning ex- 
periences together. 

Cooperative planning by the faculty 
of the school of nursing, in relation 
both to master plan construction and 
teaching programs in various areas of 
the curriculum, will be necessary in 
order to ensure continuity of learning 
experiences for the student. 
Sequence : — Is related to continuity, 
but goes beyond it. Each successive ex- 
perience is not only built upon the 
preceding one, but goes tnore broadly 
and deeply into the matters involved. 
Higher levels of treatment are involved. 
Thus, sequence of clinical experiences 
is important, in master plan construction. 
Desirably, these proceed from the sim- 
ple to the complex. It is a tribute 
to the master plan of the educational 
program when a student remarks, at 
the end of her course "I felt that I was 
ready for each new clinical experience 
as it came along ; one experience seem- 
ed to lead to the next." To preserve 
the principles of continuity and sequence, 
tools and techniques are developed 
whereby the teachers in the wards are 
able to ascertain readily the level in 
the program of students assigned to 
them, and the experience background 
of each student to date, as well as 
their present learning needs. 
Integration : - — Helping the student 
to get a unified view and to unify 
her behavior in relation to the ele- 
ments dealt with. 

In commenting on this criterion, one 
would note that such experiences provid- 
ed in the senior year, e.g.. a final period 
in general medical and surgical nursing, 
a rural hospital affiliation, experience in 
the emergency ward, etc., provide ex- 
cellent opportunities for the student to 
integrate her learning during the basic 
course. 

5. Availability of the clinical ex- 
periences required to realize the aims 
of the education program : Before 
commencing to construct the master 
plan of rotation, it is necessary to 
assess the available clinical resources 
afforded both by the home school and 
by affiliation with other schools and 
with community health and welfare 
agencies. 



JANUARY. 1959 • Vnl. 55. No. 1 



31 



6. Adequacy of the available clini- 
cal resources: This is judged by: 

a. The quantity of experience avail- 
able — the absorption power of the 
wards, departments, and agencies, in 
relation to the number of students 
requiring the experiences. 

b. The quality of experience avail- 
able, based on various factors, such as 
the variety of clinical conditions es- 
sential to provide a well-rounded ex- 
perience, activity of the clinical serv- 
ices, length of patient stay, etc. 

c. The staffing of the nursing service 
in areas in which students are to re- 
ceive experience, so as to ensure good 
patient care and to safeguard the edu- 
cational program for students : 

adequate numbers of registered nurses 
and auxiliary nursing personnel to 
stabilize the service. 

qualified head nurses and supervisors, 
to promote best utilization of resources, 
including staff. 

availability of qualified clinical instruc- 
tors in all clinical areas, to plan, 
direct, and supervise the educational 
program i^i the wards. 

d. Close working relationships be- 
tween the nursing service and the 
school of nursing, with deep mutual 
understanding^ of the aims of service 
and school, and mutual support one 
of the other. 

7. Desirability of maintaining uni- 
forin numbers of students in wards 
or services at all times: Insofar as 
this is consistent with the learning 
needs of the individual students ; the 
importance of the school of nursing 
advising the nursing service, well in 
advance of a budget period, of the 
maximum numbers of students antici- 
pated weekly for assignment to each 
clinical area for the budget period. 

Construction of the Master Plan 

Bearing in mind the basic factors 
governing the planning of students' 
clinical experience, the actual steps in 
the construction of the master plan for 
each class are as follows : 

1. The faculty of the school of nurs- 
ing designs the educational program 
for the class entering the school : 
a. Program of theorical instruction is 
planned — courses, hours, placement of 
courses, pattern of instruction (block, 
modified block, study days, correlated 



instruction given during experience in 
clinical area). 

b. Length of clinical experience in 
each service is determined, and whether 
the experience is to be taken at one time, 
or at various levels throughout the pro- 
gram. Method of securing correlation 
between theoretical instruction and ex- 
perience is discussed. 

c. Sequence of clinical experiences is 
recommended. 

d. Recommendations are made by 
clinical instructors regarding desirable 
frequency of rotations into each ward 
or department. 

e. Programs of special groups are con- 
sidered, e.g., students affiliating from 
schools of nursing situated in special 
areas such as, mental hospitals, uni- 
versities, etc. Requirements of the cur- 
ricula in schools sending affiliates are 
reviewed. 

2. The faculty member responsible 
for student nurse rotations then pre- 
pares the master plan of rotation for 
the new class. This may be done two 
or three weeks following admission. 

The Nursing Arts Instructors are usual- 
ly responsible for assignment of students 
to wards, for one or two hours daily, 
during the first term, September-mid- 
November inclusive. 
Hence the Master Plan is designed to 
cover the program from the fifth 
to the thiriv-sixth month inclusive. 
Names of students are placed on the 
plan late in October, after there has 
been an opportunity to evaluate the 
specific potentialities and needs of the 
individual student. 

3. Procedure in making Master 
Plan : 

a. Secure suitable graph paper. 

b. Fasten sheets together, using 
gummed tape on the back of the sheets 
to make one large sheet, big enough 
to accommodate the names of all stu- 
dents, and one graph square for each 
of the weeks for which the program is 
planned. 

c. Leave on the left a column for 
students' names, and place number op- 
posite each space, including all stu- 
dents in the class. 

d. Along top of sheet, place the 
dates for the beginning of each week, 
for the entire period of the basic 
course. 

e. Block out the periods of block 
instruction or major curriculum areas, 



32 



THE CANADIAN NURSE 



for the entire period of the basic 
course. 

f. Plot affiliations : If one class is 
taken into the school yearly, each class 
is entitled to the equivalent of one 
year's experience in any given affilia- 
tion. 

If four students are sent every eight 
weeks for affiliation at the provincial 
mental hospital, (52/8) or 61/2 rotations 
are made yearly into this area, which 
means that (6^ x 4) or 26 students 
may have this experience yearly. Thus, 
if one class enters yearly, 26 students 
of that class may have the affiliation and 
provision for this will be made on the 
Master Plan. If two classes should enter 
yearly, each class will have a proportion 
of 26, depending on the size of the class. 
In placing the affiliations on the 
Master Plan, thought must be taken 
of prerequisites for each affiliation, and 
its placement in the educational pro- 
gram. 

It goes without saying that af- 
filiation contracts must specify the 
number of sttidents who may affiliate 
at one time, and the home school must 
keep faith with the affiliation agency. 
This means a steady inflow of students. 
In making the Master Plan, affiliations 
far the new class will follow immedi- 
ately those of the preceding class, with- 
out break in continuity. 

g. Plot the remainder of the ro- 
tation plan, service bv service. Here, 
as with affiliations, each class is entitl- 
ed to one year's share of a given ex- 
perience, e.g. Diet Kitchen or Emer- 
gency. Again, one Master Plan must 
dovetail with the preceding one, so 
that there is a steady inflow of students 
into the various clinical areas. 

Planning the rotation 
for any one .service 

1. Analysis of the absorption poiver 
of the service : 

This may be done by various 
methods. Information required : 

a. daily average of patients in the 
ward or number of patient days, month 
by month, for a twelve-month period: 

b. standard hours of care approved 
per patient day, for that ward or 
service ; 

c. seasonal fluctuations in census, if 
any; 

d. percentage of care to be given 



by professional (graduate and student) 
and non-professional nursing person- 
nel ; 

e. percentage of professional care 
to be given by graduate nurses and 
by student nurses; 

i. hours of teaching time for stu- 
dents weekly ; 

g. hours of dutx for students week- 
ly ; 

h. effectiveness factors of students 
at various levels in the program, i.e. 
value of student service in terms of 
graduate nurse efifectiveness ; 

i. hours worked daily, weekly and 
yearly by graduate nurses and aux- 
iliary nursing personnel. 

Example : Ward A is a Women's 
Medical ward of 30 beds, with a daily 
average of 25 patients. Patient days year- 
ly are 9125, and the census remains fairly 
constant throughout the year. Standard 
hours of care approved for this ward are 
3.4 per patient day. Of the general nurs- 
ing care given, 65% is to be given by 
professional and 35% by non-professional 
nursing personnel. Professional hours of 
care include those given by general staff 
nurses, and hours of student nurse serv- 
ice, equated in terms of graduate ef- 
fectiveness. Effectiveness factors recog- 
nized in this hospital and school of 
nursing are : Senior students, 90% : 
intermediate students, 75% ; and junior 
students (after the first eight months) 
50%. Junior students, during the first 
four months have an effectiveness fac- 
tor of 0, and during the next four months 
(Medical-Surgical block period) 33%%. 
Of the professional care given, half 
is to be by general staff nurses, and 
half by student nurses. 

General staff nurses give 1844 general 
nursing hours yearly, exclusive of week- 
ly, annual and statutory holidays and 
average sick time. 

Certified Nursing Aides give 1912 
bedside nursing hours yearly, exclusive 
of holidays and sick time. 

Students have a 48-hour week, includ- 
ing 3 hours of class time and an average 
of 2 hours of "allowable" sick time. 
Bedside nursing hours weekly, there- 
fore, total 43. 

To compute tlic numbers of students 
ivho may be rotated through this ivard 
weekly and yearly : Number of bedside 
nursing hours required yearly, i.e. for 
9,125 patient days, at 3.4 hours per 
patient day; 9.125 x 3.4 = 31,025 



JANUARY, 1959 • Vol. 55, No. 1 



33 



Number of hours to be given by 
professional personnel : 65% x 31,025 = 
20,166 

Number of hours by iwii-professioiial 
personnel = 10,859 

Half of professional nursing care, or 
(20.166 -^ 2) or 10,083 hours are to be 
given by general staff nurses. 

General staff nurses required: (10,083 
-^ 1844) = 5.4 (5.6) 

Half of professional nursing care is 
to be given by students, or 10,083 hours. 
Of this, one-third is to be given by 
seniors, at 90% effectiveness ; one-third by 
intermediates, at 75% effectiveness ; and 
one-third by juniors at 50% effective- 
ness. 

In order to give 3361 professional 
nursing hours, senior students would 
have to give 100 -:- 90 x 3361 or 3734.4 
hours. 

In order to give 3361 professional 
nursing hours, intermediate students 
would have to give ^00 ^ 75 x 3361 
or 4481.3 hours. 

In order to give 3361 professional 
nursing hours, junior students would 
have to give 100 ^ 50 x 3361 or 6722 
hours. 

One student would give 43 hours 
weekly x 52 weeks in year or 2236 stu- 
dent bedside nursing hours yearly. 

Number of senior students who could 
have experience at all times in Ward A , 
throughout the year, would then be 
3734 ^ 2236 or 1.06 (1-2) 

Number of iiitcnnediafc studoits who . 
could have experience at all times in 
Ward A throughout the year, would 
then be 4481 -f- 2236 or 2.0 

Number of junior students who could 
have experience at all times throughout 
the year would be 6722 -^ 2236 or 3.0 

Total number of students who could 
receive experience at one time in this 
ward would then be seven. 

Number of non-professional nursing 
personnel required (10,859 -:- 1912) or 
5.6 (5-6) 

2. 2nd Step in Plaiiniiu/ Rotations 
by Ser7'ices 

Estimate the number.s of student.s 
of this class who should be in the 
particular ward or service at one time. 
by taking the length of experience 
required by the curriculum plan. For 
example : Diet kitchen — 6 weeks. 
This would make (52 -^ 6) or 8 2/3 
rotations yearly. If one class yearlv 
is admitted, then for a class of 100 



the number who should be in the diet 
kitchen at one time should be (100 -f- 
8 2/3) or 11.5 (11-12). If students 
are sent into the diet kitchen every 
two weeks, four will be sent at one 
time. 

3. Check the number of students 
who should be sent into the given 
clinical area against the known ab- 
sorption power of the service. If the 
number should exceed that which can 
be accommodated satisfactorily, this 
is a problem which should be con- 
sidered by the faculty as a whole, and 
by the administrative officials of the 
hospital and the school of nursing. 
(Such a problem should be detected 
in advance of class admission). 

Solution of this problem may be 
sought and found in various ways : 

a. By decreasing the length of time 
students will spend in the area, always 
considering, however, the minimum time 
necessary to satisfy registration require- 
ments and the learnings needs of the 
students. 

b. By expanding the clinical facilities 
in that area, for example, in the case of 
diet kitchen — using the wards as the , 
laboratory for student experience. This 
would necessitate a teaching dietitian on 
the wards. 

c. By seeking resources for student ex- 
perience in the community health and 
welfare agencies. 

4. Having determined the number of 
students who should and can be rotated 
at one time into a given service, and 
the frequency of such rotation, plan 
the rotations for that service for the 
entire class, making sure that the first 
students go into the area at the correct 
time, to "link up" with those of the 
]M"evious class completing their ex- 
])erience therein. 

5. Plan the rotations for every other 
required service in a similar way, one 
after the other. 

6. Plan holiday times so as to space 
tliese as evenly as possible through 
the holiday months. Holiday months 
will be planned to avoid periods of 
heavy class schedules, and periods of 
depletion of available student service 
for other reasons 

e.g. class graduating at end of August ; 
new class having no "service" value 
for fall months, September-December. 

7. In planning rotations, endeavor 
to arrange for practice in given clini- 



34 



THE CAN.^DIAN NURSE 



lut services os soon as possible jol- 
lozving the classes in the related sub- 
jects. Studies have shown that a typical 
student will forget 50% of what she 
learned, after the first year, and 75% 
after the second year, unless oppor- 
tunity to apply and consolidate learn- 
ing in practice has been provided. 

8. While the Master Plan is still 
in the draft stage, have it reviewed 
by the associate director of nursing 
education and individual instructors 
concerned. If there are matters aris- 
ing out of the evolving plan which 
are of particular concern or interest, 
have it reviewed, before finalizing, 
also by the other persons who may 
have some relationship to it, e.g. the di- 
rector of nursing, the associate di- 
rector of nursing service, the director 
of nursing (or her representative) 
of the school or schools sending af- 
filiates, etc. 

9. Also, before finalizing the Master 
Plan, make a summary of the experi- 
ences (in weeks or days) for all stu- 
dents provided therein. This is essen- 
tial, to make sure that. the curriculum 
"prescription" has been followed and 
achieved. 

10. Before putting the students' 
names on the plan, the following steps 
may prove helpful : 

a. The faculty member who made the 
plan may speak to the class, usually 
in groups, about the experiences which 
have been included therein, their length, 
sequence, and relationship to the total 
curriculum. 

b. She may invite the students to ex- 



press their preferences for or against 
certain affiliations ; and to state any 
reason for preferences in regard to 
annual vacation. 

c. Requirements of certain students or 
groups of students for certain experi- 
ences will be considered, and these will 
be interpreted, also, in speaking to the 
students. 

d. Through the associate director of 
nursing education, in conferences with 
both classroom and clinical instructors, 
an evaluation will be secured of the de- 
velopment of the various students to 
date. Emotional maturity and readiness 
for certain experiences (e.g. operating 
room) will be ascertained. Care will be 
taken, in putting the names on the plan, 
to provide combinations of students 
which will make for most effective 
development of the individual student. 
The service, too, is considered in this 
arrangement. One advantage of having, 
in groups of students, some "good", 
some "better" and some "best" is found 
in the withdrawal factor : it is im- 
portant, both for scnbol and service, 
that large withdrawals should not take 
place from one area of the Master Plan. 

11. Considering all of the foregoing 
factors, the students' names are then 
put on the Master Plan. 

12. Each student's plan is then dis- 
cussed with her individually, and she is 
advised that it will be in order for her 
to see it at any time. 

13. The completed plan is then re- 
\iewed by the faculty, the head nurses, 
supervisors, and others to whom it 
shotjld be interpreted. 



To be concluded next month 



Alive and Well 



The many friends of Mrs. Ruth .A. Hillman. 
a 1950 graduate of Hamilton General Hos- 
pital, will be delighted and thankful to know 
that she is still very much alive. .\n item 
reporting her death was included in our 



November issue following the rcccij)! of 
erroneous information. 

Mrs. Hillman is currently enrolled in the 
course in public health nursing at the Univer- 
sitv of Western Ontario, London. 



Plans for retirement should include more 
than dreams of travel or just loafing. A 
few weeks of idling can lead to boredom, an 



undesirable condition for older retired people. 
Prepare for hobbies and interesting occupa- 
tions when vou leave work. 



JANUARY. 1959 • Vol. 55. No. 1 



35 



Alnrsing Profiles 



Last October a valued member of the 
nursing profession retired from active serv- 
ice when Ethel Cryderman left her position 
as District Director of the Toronto Branch 
of the Victorian Order of Nurses, one that 
she held since 1934. During that time she 
saw this branch survive the hardships of the 
depression years, the stress of World War II 
and the unprecedented growth of the Toronto 
area with its attendant changes and pro- 
blems. Under her direction the work of the 
Toronto Branch has more than doubled. Its 
standard of nursing service has been raised 
and new functions have been added until to- 
day it has a reputation for providing a high 
calibre of community nursing service. This 
achievement is recognized by her colleagues 
as a reflection of Miss Cryderman's able 
administration. Her years of service have been 
characterized, too, by a sharing of her ex- 
perience to provide preparation for other 
nursing leaders. Many nurses who worked 
with Miss Cryderman now hold key posi- 
tions in Canadian nursing. 

Miss Cryderman's capacity for hard work 
is evident in the responsibilities that she 
has assumed in addition to those of her job. 
She has been active throughout the years on 
innumerable committees in community-wide 
organizations. As a member of the board of 
directors of the Community Chest and as a 
member of the Welfare Council her dynamic 
thinking has contributed in no small measure 
to the development of the health and welfare 
services of her community. 

The Canadian nursing profession as a 
whole has been greatly enriched by Miss 
Cryderman's generous sharing of her talents. 
She has been chairman of, and associated 



with, numerous committees of professional 
nursing organizations — local, provincial, 
national and international. In addition to 
being president of her own alumnae associa- 
tion and of the Registered Nurses' Associa- 
tion of Ontario, Miss Cryderman assumed 
the heavy tasks of president of the Canadian 
Nurses' Association from 1948 to 1950. 

A graduate of Toronto General Hospital, 
Miss Cryderman received her certificate in 
public health nursing from the University of 
Toronto. She obtained further training in 
midwifery at Radcliffe Infirmary, Oxford, 
Eng. and in mothercraft in London. 

Miss Cryderman saw military service with 
the R.C.A.M.C. during World War I, was a 
staff nurse and district supervisor with the 
Toronto Department of Health and, from 
1929 to 1934, she was a central office super- 
visor with the Victorian Order of Nurses 
for Canada. During this time she organized 
and conducted institutes in maternity nursing 
throughout Canada. 

Miss Cryderman looks back with great 
pleasure on the many vacations that she has 
spent canoeing and hiking in the Canadian 
outdoors. In spite of her busy life she 
found the time and energy to gain enough 
experience in mountain climbing to make her 
graduation climb. Reading has always claim- 
ed her interest and she enjoys sharing her 
reading experiences through discussion. 

Her dynamic leadership will be sadly 
missed by those who have worked most 
closely with her. But all who know her will 
rejoice with her that she can now enjoy a 
more relaxed life. Her warm interest in peo- 
ple will remain and guarantee a continuing 
absorption in nursing and community affairs. 




Ethel Cryderman 



Irene Bernice Seeds is the new district 
director of the Toronto Branch of the 
Victorian Order of Nurses. A graduate of 
Toronto Western Hospital in 1938, Miss 
Seeds obtained her Bachelor of Nursing from 
McGill University's School for Graduate 
Nurses in 1947 and her certificate in adminis- 
tration and supervision from the University 
of Toronto in 1951. 

Following her graduation from T.W.H. 
she remained on staff for several months 
before engaging in private duty for a short 
time. Then World War II began and Miss 
Seeds joined the R.C.A.M.C. in September, 
1939. During the next six years she served 



36 



THE CANADIAN NURSE 



in Canada, England, North Africa and 
Italy. Upon her return to Canada, she 
entered McGill University for postgraduate 
work and joined the Victorian Order of 
Nurses as a staflf nurse in Vancouver upon 
completion of her studies. A year later she 
came back to her native province, Ontario, 
where she joined the Northumberland- 
Durham Health Unit. Her next move was 
to the Toronto Branch of the V.O.N, where 
she has served successively as a senior 
nurse, second and first assistant director. 

Membership in the Nursing Sisters' 
Association, Toronto Unit, keeps her in touch 
with friends who shared her wartime ex- 
periences. Ofif duty Miss Seeds likes to try 
her luck at fishing or photography. The best 
wishes of her friends go with her as she 
begins her new duties of directing the activi- 
ties of this busy V.O.N, branch. 

The University of Western Ontario School 
of Nursing has announced the appointment of 
Ruth Catherine Aikin to the faculty where 
she will teach in the nursing education pro- 
gram. Born in Prince Albert, she received 
her early education in Winnipeg and West- 
mount, P.Q. A graduate of the Montreal 
General Hospital in 1938, she engaged in 
staff and private nursing for some time and 
then took up occupational health nursing 
with Canadian Car Munitions Ltd. in 1941. 
Three years later she joined the R.C.A.M. 
C. and eventually went to England with 
No. 11 Canadian General Hospital. 

Following her discharge from the services 
Miss Aikin entered McGill University for 
postgraduate study. She completed require- 
ments for her B.A. in 1948 and for her B.N. 




in 1949. A year at M.G.H. as instructress 
of nursing was followed by appointment to 
the staff of the Quebec provincial office 
where she became the assistant secretary- 
registrar of the A.N.P.Q. In 1952 she went 
to Calgary General Hospital as educational 
director where she remained until she ac- 
cepted her present appointment. 

With the retirement of Dora Parry from 
the position of director of nursing — a role 
she has filled since 1938 — the Montreal 
Children's Hospital bids a reluctant farewell 
to one of its most devoted members. 




Van Dyck — Montreal 

R. Catherine Aikin 



Dora Parry 

The Children's Memorial Hospital has 
been a part of Miss Parry's life since she 
first entered its doors as a student nurse in 
1921. Immediately upon graduation she joined 
the staff first as acting night supervisor and 
then successively as operating room super- 
visor (1924-30), acting superintendent for 
a few months, assistant superintendent (1936- 
38) and superintendent (1938-58). One year 
was spent at the McGill School for Graduate 
Nurses while Miss Parry secured her certifi- 
cate in administration in schools of nursing. 
In 1935 she returned to England for a year's 
visit — Miss Parry was born in Wigan, 
Lancashire. 

Through the years she has watched her 
hospital grow in prestige as well as phy- 
sical size. Although the hospital discon- 
tinued the training of nurses some time ago, 
nursing education is one of its major func- 
tions. Hundreds of student nurses from hos- 
pitals throughout the province have received 



JANUARY, 1959 • Vol. 55, No. 1 



37 



their experience in the care of children 
under the guidance of the teaching staf?. 
The pediatric program for students of 
medicine is recognized by universities as one 
of the best of its kind. More recently 
developments in cardiac surgery and the 
successful treatment of children with heart 
lesions have brought the hospital to the 
attention of the general public. 

It must have been with a sense of deep 
pride and accomplishment that Miss Parry 
took part in the move from the buildings 
perched on the side of Mount Royal to the 
spacious and modernized quarters of the 
hospital's new site in downtown Montreal. 
Some time before that event, the familiar 
name of "Children's Memorial Hospital" 
was replaced by "Montreal Children's Hos- 
pital." No doubt this change brought twinges 
of regret to some, but it is in keeping with 
the general development of the hospital in 
medical life. 

In 1946, a milestone in Miss Parry's pro- 
fessional career — her 25th year of associ- 
ation with the hospital — was marked by 
appropriate celebration. Now her friends and 
colleagues are recognizing another milestone 
in her life and their good wishes will follow 
her into the future. 

Occupational health nursing within recent 
years has come to be an important branch of 
onr profession. Managers in industry have 



recognized the value of the nurse in reducmg 
absenteeism due to illness and maintaining 
the general efficiency of the plant. No doubt 
the workers have come to appreciate more 
and more the presence of one whose sole 
interest lies in them. The scope of the work 
of the average nurse in industry can be 
illustrated by the career of Yvonne Martel 
who is presently the occupational health 
nurse at the Miner Rubber Company Ltd., 
Granby, P.Q. 

A graduate of Misericordia Hospital, 
Montreal, Miss Martel gained knowledge of 
nursing in industry through special courses 
of study in Montreal, Ottawa and Boston, 
Massachusetts. One of her first assignments 
was to organize First Aid units for the 
Foundation Company of Canada, Shipshaw, 
P.Q. This was done at a time when the plant 
was organizing for wartime production. Later 
Miss Martel undertook a somewhat similar 
task at St. Paul I'Ermite when she organiz- 
ed a company hospital. She has, since then, 
set up First Aid units for the Julius Kayser 
Company of Canada, Sherbrooke, P.Q. and 
spent some time in occupational health nurs- 
ing in British Columbia. After joining the 
Miner Rubber Co., she reorganized First 
.Md facilities for the employees. 

The young graduate with an interest in 
public health nursing would find the field 
of occupational health nursing a very stimu- 
lating one. 



Measurement of Sonnd 



The unit of sound measurement is the 
decibel. The decibel scale progresses from 
a zero reading when no sound exists to a 
reading of 110, at which level sound is so 
intense as to be painful. The most active 
hospital areas may have a decibel level of 
between 50 and 70. With acoustical treat- 
ment, such a level can be reduced as much 
as 10 decibels. 

Decibel Scale 



50 — Congested department store 

Average restaurant 
40 — Average schoolroom 

Quiet automobile 
30 — Public library 

Quiet residence 
20 — Rustling paper 

Average whisper 
10 
— Threshold of hearing 

— National Gypsum Company 



110 — Threshold of pain 
Thunder, artillery 
100 
90 — Newspaper press room 

Jackhammer drill at 10 ft. 
80 
70 — Average machine shop 

Stenographic room 
60 



A good education is the passport to the 
great adventures of life. But to really en- 
able us to go places that passport must be 
stamped again and again with the visas of 
experience and continuing education. 

— Walter Cisi.er 
* * * 

A closed mouth catches no flies. 

— Miguel de Cervantks 



38 



THE CANADIAN NURSE 



Faith and Loyalty 



Martha Riley 

(if OYALTY IS A BEAUTIFUL WORD, and 

JU it means the quality of being 
constant and faithful in any relation 
implying trust or confidence — of 
bearing true allegiance to constituted 
authority, of professing faithful de- 
votion. "2 Faith is confidence, as faith 
in yourself, faith in God, faith in your 
family and friends, and faith in your 
profession. These so closely related 
virtues of faith and loyalty are ne- 
cessities for every person in every 
walk of life. "Loyalty implies being 
faithful, "4 therefore, if you have faith, 
it also follows that you will be loyal. 

Regardless of who you are or what 
your position and status in life may 
be, before you can be faithful and loyal 
to anything or anyone, you must be 
faithful and loyal to yourself. You are 
an individual, a personality in your- 
self — there is no exact duplicate of 
you anywhere in this universe, as no 
two personalities are exactly alike. Be- 
fore you can satisfy any of your 
dreams, you must have faith in what 
you are reaching for and you must be 
ioval to that aim, no matter how diffi- 
cult the road may be. Whether your 
fondest desire is to take a trip around 
the world or to be the finest nurse yet. 
you must have confidence in yourself 
and believe in what you are doing. Be- 
fore you can be truly faithful and loyal 
to yourself, you must develop the 
additional traits of dependability, sin- 
cerity, and gratitude. It is one thing 
to know the importance of being faith- 
ful and loyal to yourself ; it is quite an- 
other thing to carry it out. Always 
remember that it is yourself that you 
have to live with all the days of your 
life. 

The Bible tells us that "Faith is the 
confidence of things hoped for, the 
evidence of things not seen. "3 Further 
it tells us that "Without faith it is 
impossible to please Him : for he that 
Cometh to God must believe that he is, 
and that He is a rewarder of them that 

Miss Riley is in her first year in 
training at Misericordia Hospital, Win- 
nipeg, Man. 



diligently seek Him. "3 Your religious 
beliefs begin to develop in very early 
life, as they are influenced by your 
parents and your environment. Your 
religious beliefs should be your strong- 
est beliefs — ones to which you will 
hold long and fast, regardless of how 
tough the going may be. It is so im- 
portant to have faith in God and to be 
lo)'al to Him, for He is a part of each 
one of us. 

Faith and loyalty towards your 
family and friends are very important, 
for they are the ones closest to your 
heart, the ones in whom you want to 
be able to confide. Your family has 
been with you since the beginning of 
your existence, and you owe a great 
deal to them. Your true friends have 
stayed and will stay with you through 
thick and thin. They deserve your 
faith and loyalty. Trust them — have 
confidence in them — know and believe 
that they are trying to help you and 
do what is best for you. Remember 
that the advice that may seem so wrong 
at first, is, in the long run, so often 
the best advice you will ever receive. 
The faith and loyalty that you show 
towards your family and friends will be 
sincerely rewarded for they will return 
that faith and loyalty to you. 

Behind the desire to become a nurse, 
there must be a great deal of faith and 
loyalty. The road that leads to "R.N." 
is far from an easy road, but it will be 
a very rewarding one if it is travelled 
with these qualities ever before you. 
The nurse must be faithful and loyal 
towards the ideals of life, the patients, 
the nursing profession, her fellow stu- 
dents, the doctors, her superiors, the 
school, and the hospital. She must have 
confidence in all of these so that she 
will be able to inspire confidence in 
others. Not every nurse can be at the 
top of her class, but every one can 
be faithful to the trust that is reposed 
in her. "A nurse can receive no higher 
recommendation than 'Thou hast been 
faithful.' "1 

In summarizing the attitudes and 
principles of faith and loyalty, it might 
be well to review the admonitions 



JANUARY, 1959 • Vol. 55, No. 1 



39 



given by Florence Nightingale :s 



woman of delicate and decent feeling. 



And remember, every nurse should be 
one who is to be depended upon, in other 
words, capable of being a 'confidential' 
nurse. She does not know how soon she 
may find herself placed in such a situ- 
ation; she must be no gossip, no vain 
talker; she should never answer ques- 
tions about her sick except to those 
who have a right to ask them ; she must, 
I need not say, be strictly sober and 
honest ; but more than this, she must 
be a religious and devoted woman ; she 
must have a respect for her own calling, 
because God's precious gift of life is 
often literally placed in her own hands ; 
she must be a sound, and close, and 
quick observer ; and she must be a 



Bibliography 

1. Aikens, C. A. (R.N.), Shidics 
in Ethics for Nurses. W. B. Saunders 
Limited — Philadelphia and London. 

2. Gareche, Ethics and the Art of 
Conduct for Nurses. W. B. Saunders 
Company — Philadelphia and London. 

3. Holy Bible — Book to the Hebrews 
— Chapter 11 — Verses 1 & 6. Author- 
ized King James Version. 

4. Morrison, L. J., Stepping Stones 
to Professional Nursing. The C. V. 
Mosby Company — St. Louis, 1957. 

5. Nightingale, Notes on Nursing. 
J. B. Lippincott Co., Philadelphia and 
Montreal. 



Health Work on Okinawa 



Sister Mary Carmel, F.M.S.I. 



KAZUKO Angela Sakikara is Okin- 
awa's only Catholic Child's Welfare 
worker. Kazuko's family live on Yae- 
yama Island. We first heard of Kazuko 
in 1955 when she was in Tokyo com- 
pleting her college course. She had un- 
dertaken college on her own savings 
and at the beginning of her senior 
year she realized that her money would 
not hold out. At first she considered 
going back to work until she had saved 
enough, but then she decided to write 
to her brother and ask him to go to 
the Mission, and explain her situation. 
If the Mission would see her through 
her last year in college, she promised 
that she would return to Okinawa and 
help in its work. The result was that 
Kazuko's senior year was made secure. 



Sister Mary Carmel is the superior of 
The Mission conducted by the Daughters 
of Mary, Health of the Sick of Vista 
Maria, Cragsmoor, N.Y., on the out- 
skirts of Naha, capital of the war- 
famous island of Okinawa. From Bar- 
naby River, N.B., Sister is a graduate 
of Hotel Dieu, Chatham, N.B. She has 
worked at Halifax Infirmary, Ottawa 
Civic Hospital and St. Joseph's Hospi- 
tal, Saint John, N.B. 




,\ .:.:jko and Sister 

In 1956 Kazuko returned to Okin- 
awa and joined the Child's Welfare 
Office. She has been a valuable as- 
set to the Mission. Her friendly, easy 
manner soon puts the poor abandoned 
people with whom she works at ease. 

One Saturday morning we picked 
up Kazuko at her office to take her 
to see one of our home patients, Taka- 
mine-san. We wanted to obtain the 
correct and necessary information so 
that the family could receive govern- 
ment help. As soon as she was set- 
tled in our little car, Kazuko started 
a lively conversation that lasted as 
long as the ride. As we drove slowly 
along the narrow road attempting to 
keep our car out of reach of small 
children and their little pals — small 



40 



THE CANADIAN NURSE 



puppies — Sister Mary Annunciata 
and I recognized a young friend, 
Eishin, a boy about 12 years old. Just 
as we slowed down to greet Eishin, 
Kazuko called out excitedly "That's 
one of my boys ! Stop ! Stop !" 

Sister brought the car to a com- 
plete stop to get the situation clear. 
It turned out that Eishin was a child 
welfare case. He and his father live 
alone. His father loves him very much 
but he loves "sake" too. Because of this 
latter love the poor man spends a good 
deal of time in the local jail. During 
these times Eishin is cared for by child 
welfare and goes to school every day. 
But as soon as his father is free, the 
first thing he does is bring Eishin home 
which always ends his schooling. The 
father just doesn't seem to understand 
that his son should be in school. 

We all went with Eishin to have 
a word with his father. As we opened 
the door of the one-room home, we 
were met by a strong aroma of sake. 
The man we wanted to talk to was 
sound asleep. We succeeded in awaken- 
ing him and he quickly sat up, bowed 
and smiled pleasantly. Kazuko began 
giving him a little advice and stressed 
the importance of sending Eishin to 
School. The gentleman agreed with 
every word, but I think he was glad 
when we left, so he could go back to 
sleep and Eishin back to play. 

The little boy often visits our clinic 
and we give him lunch. When we 
mention school, he is always just going 
or just coming from there. He has 
little love for studies. 

We finally continued on our way 
to see Takamine-san. After five days 
of continuous vomiting, he was happy 
to hear that there was a chance to 



admit him to a government hospital. 
Takamine-san's wife died a few months 
ago. Since then he has been very sick. 
Trying to care for his two children 
— a little girl, 10, and a boy, 7 — 
was a constant worry. 

That day the little boy was sick 
too. His tiny bed took up most of the 
floor space. The small girl tried to help 
her father. They had a little dog too, 
and the house was so cramped that we 




:ing out of doors 

had to let him out to get in. The kitchen 
was out behind the house in a cave dug 
in the hillside. Each time we have visit- 
ed we have taken them food, otherwise 
there never seems to be any food a- 
round. Maybe the little girl goes to 
market for something just before they 
need it to prepare a meal. 

Eventually, with Kazuko's help the 
necessary government forms were in 
order. Takamine-san was admitted to 
the hospital for surgery. 

The children were heartbroken when 
they had to leave their father. The boy 
held on to the dog so determinedly 
that the welfare officials allowed the 
children to bring him along. The next 
time we visited the children we got 
the usual greeting from the dog who 
was tied with a short rope outside the 
building. We were told that he was 




Visiting a sick boy 

JANUARY. 1959 • Vol. 55, No. 1 



Going home from hospital 



41 



eating well and growing. The children 
were happy and going to school regu- 
larly. But when we visited the father 
— the hospital was right next door — 
he cried almost all the while we were 
there because he was so lonesome for 
the children. Surgery was scheduled for 
the following morning. We gave him 
some candy and games to give the 
children when they came in to see him 
before operation. 



About four days after surgery we 
visited Takamine-san again and found 
that he was making wonderful pro- 
gress. He was all smiles and very 
happy over the success of the surgery. 

Takamine-san and his family did 
not return to their former home. The 
government rented a big room for 
them. We are continuing to visit him 
regularly and he is getting along most 
happily. 



The Venereal Disease Clinic 



Magdai.kne Schroeter 



ONE Monday we were scheduled for 
a field trip to the Venereal Disease 
Clinic which is held at the Outpatient 
Department of St. Boniface Hospital. 
This was part of our course in com- 
munity health. The purpose of the 
visit was to point out the ways in 
which the problem of venereal disease 
is handled by health authorities in 
the City of Winnipeg in order to give 
us a better insight in the different 
aspects of V.D., to understand the 
importance of such a department for 
the affected person in particular and 
the community as a whole, and to give 
us an opportunity to observe the ways 
by which this plan is carried out in 
practice. 

We reported to the public health 
nurse on duty, who in turn introduced 
us to the physician in charge. The 
doctor gave us an outline of the medi- 
cal treatment of both gonorrhea and 
syphilis, pointing out the difficulty in 
making a clinical diagnosis for gonor- 
rhea. He mentioned the sugar-fermen- 
tation test which is a specific laboratory 
test for gonorrhea, difi^erentiating the 
causative organism of this disease 
from other non-specific, gram-negative, 
intracellular diplococci which often 
erroneously are thought to be gono- 
cocci. This may happen in young girls 
who have a vulvovaginitis the smear 



Originally from Germany, Miss 
Schroeter was a student at Misericordia 
Hospital. Winnipeg, when this report 
was written. 



of which contains gram-negative intra- 
cellular diplococci. In men, on the other 
hand, there sometimes are the symp- 
toms of Reiter's syndrome which lead 
to a wrong diagnosis. The latter is 
typical of urethritis, conjunctivitis, and 
arthritis thus mimicking the symp- 
toms of gonorrhea but caused by a non- 
specific organism. 

In general, the diagnosis of gonor- 
rhea is established only after the labo- 
ratory report from the smear taken, 
comes back, but treatment is started 
at once on the basis of clinical findings. 
A very large dose of penicillin — six 
billion units — is given to combat lues 
plus two million units to combat gonor- 
rhea since these diseases are often 
found simultaneously in one person. In 
lues up to nine million, even 12 million 
units will be given or courses repeated 
where indicated. Wassermann tests are 
taken routinely on every patient 
whether he comes in for the treatment 
of lues or gonorrhea. 

Before treatment with penicillin is 
started, the patients are always ques- 
tioned whether or not they know if 
they are allergic to the drug. Should 
this be the case, then terramycin is 
substituted for penicillin. The dis- 
advantage of the latter treatment is the 
high price of terramycin. When the 
patient comes in for his injections he 
is asked every time for signs and symp- 
toms of allergy such as pruritus, etc. 
The treatment of syphilis also in- 
cludes a general physical examination 
and an examination of cerebrospinal 



42 



THE CANADIAN NURSE 



fluid if indicated. Blood tests are re- 
peated for six months or until the tests 
are negative. Follow-up treatment is 
carried out over a number of years 
in order to detect any clinical or 
serological relapses. If the patient 
during his treatment should develop 
any other illnesses, the doctor refers 
him to the appropriate department of 
the O.P.D. or may even admit him to 
hospital if necessary. Even with early 
treatment of gonorrhea, arthritis is 
sometimes a complication which might 
require hospitalization or physiothera- 
The clinic on this particular morn- 
ing was not too well attended, but 
nevertheless we had the opportunity 
to be present at an interview conduct- 
ed by the public health nurse with one 
of the patients. The patient was a 
young man, 24 years of age, who was 
being treated for the second time for 
gonorrhea. The nurse, after explaining 
to him that all his answers would be 
kept strictly confidential, tried to get 
the required information about his 
contact, but his description was very 
vague and nonspecific. He was urged 
to avoid further contacts with unknown 
people and was given some educational 
pamphlets about V.D. He also was 
asked to try and find out the full 
name and address of his contact so 
that the public health nurse could visit 
her and suggest a course of treatment 
in order to prevent further spread of 
the disease from this source. 

The information obtained from the 
patient was put on a form, one copy 
of which is sent to the Department of 
Health in Winnipeg and the other one 
to the Police Department. Although, 
as pointed out by the nurse, not all 
the contacts can be traced all the time, 
it seldom is necessary to force people. 
Reports are only sent to the police on 
those who are brought to the clinic 
by morality officers ; not on other pa- 
tients. 

Patients visiting the clinic in general 
belong to the low — or medium-wage 
groups. Most of the female repeaters 
are Indians or half-breeds who come 
from outside the city, are ill-adjusted 
and most often not too fond of work. 
Some of them deliberately ask to be put 
into jail where there is also an oppor- 
tunity to receive treatment for venereal 
diseases. Unfortunatelv, there does not 



exist any organized rehabilitation 
program for these prisoners so that 
there is great likelihood that they will 
resume the way of life they led before 
imprisonment after they are released. 

Poor housing, inadequate education, 
lack of work, and alcohol, all are un- 
favorable factors influencing this group 
of people and increasing their promis- 
cuity. Some of the female patients who 
are committed through the Juvenile 
court are detained in a sheltering 
home. Twice a week the public health 
nurse from the V.D. clinic visits these 
homes to take smears, cultures or blood 
tests and to give antibiotic treatment 
to those affected with venereal dis- 
eases. 

It sometimes also happens that one 
of the patients is pregnant. If she is 
not married she is referred to a hospi- 
tal where she can stay until delivery 
and where she has close medical super- 
vision throughout her pregnancy. Plans 
for adoption if desired will be taken 
care of in these hospitals. 

All services of the V.D. clinic are 
free of charge. The provincial govern- 
ment pays an annual flat rate to St. 
Boniface Hospital which in turn sup- 
plies the nursing services. The drugs 
for treatment are supplied by the fed- 
eral government. The staff consists 
of the physician-in-charge, two nurses 
and one clerk. Clinics are held twice 
a week in the morning and afternoon 
for both men and women, on Monday 
evenings for men and Thursday even- 
ings for women. 

The purpose and aim of the clinic 
is, of course, to give early treatment 
to all infected persons and by tracing 
their contacts to discover all other 
cases suffering from V.D. The clinics, 
although one of the most valuable di- 
visions in the fight against V.D., are 
not the only community resource con- 
cerned with the eradication of these 
diseases. As in many other diseases 
the best treatment is prevention. This 
depends upon the public's awareness 
of the facts concerning the spread of 
\enereal disease. Much can be and is 
being done by means of education 
through all the modern means of com- 
munication and publication including 
radio, television, newspapers, maga- 
zines and educational pamphlets. 

Premarital and prenatal blood tests 
are other methods for detecting early 



JANUARY. 1959 • Vol. 55. No. 1 



43 



KNOX GELATINE . . . 



a positive way 
to strengthen 



fin 



brittle 




Nobody ever died of brittle fingernails. That's not to say that 
this all too common feminine problem has not caused much 
patient distress and even some professional perplexity. 

Happily a new prognosis is possible for better than seven out of 
ten women with brittle fingernails. One to three envelopes of 
Knox Gelatine a day for three months restore strength in 
approximately 80% of patients. ^' 2. 3.4 Improvement is usually 
apparent in 30 days. 

Adequate intake of Knox Gelatine (min. 1 envelope — 7 Gm. or 
120 grains per day) is absolutely essential to produce the Specific 
Dynamic Action necessary to correct the brittle nail defect. If you 
would like to examine at first hand the clinical research establishing 
this use of Knox Gelatine, just use the coupon below. 



KNOX GELATINE (CANADA) Ltd. 

Professional Service Department 
140 St. Paul St. West, Montreal, Quebec 

please send reprints of the Jollowini^ articles: 

1. Rosenberg, S., Oster, K.A., Kallos, A. and Burroughs, W.: 
A.M. A. Arch. Dermat. 76:330, September 1957. 

2. Schwimmer, M. and Mulinos, M.G.: Antibiot. Med. & Clin. 
Therapy 4:403, July 1957. 

3. Rosenberg, S. and Oster, K.A.: Conn. State Med. J. 19:171, 
March 1955. 

4. Tyson, T.L.: J. Invest. Dermat. 14:323, May 1950. 

YOUR NAME AND ADDRESS 




before Knox 



iW0^ 







% 





K, 




4^4ln\y--i»i 



cases of syphilis. Only a small number 
of cases are actually found by these tests. 

The administration of silver nitrate 
drops into the eyes of every newborn 
baby has largely reduced the incidence 
of gonorrheal ophthalmia neonatorum 
which now is encountered very rarely, 
though it used to be a major cause of 
blindness. Another problem to be taken 
into consideration is the environment 
in which those people live who largely 
make up the clientele of the V.D. clinic. 
It is one of the main aims of all those 
concerned with the control of these 
diseases to improve the environment 
whenever possible. Abolishment of 
houses of prostitution by legal meas- 
ures as well as education in sex hy- 
giene at schools would contribute 
greatly to reducing the incidence of 
these diseases. 

The control of \enereal diseases 



is a joint project where many partici- 
pate in order to reach the goal of 
eventually eradicating them. It should 
be the responsibility of every educated 
citizen to join that campaign and to 
wholeheartedly contribute whatever is 
in his power. Nurses, whether they 
work in hospitals or in public health, 
have a responsibility to contribute their 
share in this program since they are 
more likely to come in contact with 
persons requiring care. Considering the 
devastating effects of late lues the 
nurse by observing signs and symp- 
toms and by education of the public 
can contribute a great deal in either 
preventing these diseases or in ensur- 
ing early treatment which will save 
the community a valuable citizen and 
tax-payer and prevent the patient from 
becoming a burden to himself and 
others. 



Medidne Nan 



Jean Wyatt 



THE FIRST MEDICINAL prescription 
in Canada was compounded by a 
copperhued savage. 

Jacques Cartier, early French ex- 
plorer of this continent and discov- 
erer of the mighty St. Lawrence River, 
with his party of men settled for the 
winter of 1535-36 in their ships in the 
frozen waters of this river at Quebec, 
then an Indian village. During their 
stay some of the men suffered severely 
from a strange illness unknown in 
France. 

However, a friendly Indian told 
Cartier of the native remedy — boiled 
hemlock twigs and bark ; the liquor 
to be drunk and the dregs used as a 
poultice for swelling and inflammation 
caused by the illness. 

The diseases was scurvy which oc- 
curred among the Canadian Indians 
during winter months when storms and 
heavy snows made hunting and fishing 
impossible and when there was a short- 
age of dried corn, roots and herbs. 
Thus improper foods, especially an 

Mrs. Wyatt lives in London, Ont. 



over-indulgence in salted meats, re- 
sulted in the outbreak of scurvy among 
Cartier's men. 

The story of medicine in Canada 
then, properly began with the Indian 
who had remedies for every need — 
expectorants, emetics, purgatives, as- 
tringents, even emmenagogues. He 
was expert in his application of the 
medicinal properties of roots and herbs 
he collected. 

For example the bark of the slip- 
pery elm and basswood and the resin- 
ous bark of the tamarack were applied 
to running sores. Ulcers responded 
to a treatment of the underbark and 
the juice of the juniper berry. 

The redman was a skilled bone- 
setter who cleverly reduced and care- 
fully set fractures of the bones. Splints 
of cedar were put on and padded by 
the squaws with leaves or grass. The 
limb was bound with the soft, pliable 
branches of the young birch. Disloca- 
tions were reduced by the simple appli- 
cation of force. Bruises were treated by 
the application of cold water in the 
form of a compress. 



46 



THE CANADIAN NURSE 



ACNE 



Tbistex 



degreases the skin 
and helps remove blackheads 




Fostex contains a combination of surface 
active agents (Sebulytic*) which: 

< Completely emulsify excess oil so that 
it is quickly washed oflf the skin. 




4 Penetrate and soften comedones, 
unblocking the pores and faciUtating 
removal of sebum plugs. 



FOSTEX CREAM 

for therapeutic washing of 

tkin in the initial phase of acne 

treatment, when maximum 

degreasing and peeling 

are desired. 

FOSTEX CAKE 

for maintenance therapy to 

k«ep skin dry and substantially 

free of comedones. 



Fostex dries and peels the skin 

< The Sebulytic base of Fostex dries and 
promotes peeUng of the skin . . . actions 
enhanced by the keratolytic effects of 
micropulverized sulfur and sahcyhc acid. 

*(Sodium lauryl sulfoacetate, sodium alkyl aryl 
polyether sulfonate, sodium dioctyl sulfosuccinatc.) 



Fostex is easy for your patients to vse 




< Patients stop using soap on affected skin 
areas. Instead they use Fostex for thera- 
peutic washing of the skin. The Fostex 
lather is massaged into the skin for 5 min- 
utes—then rinse and dry. 

WESTWOOD Pharmaceuficult 

Buffalo, New York 

Canadian Distributor: John A. Huston Company, Ltd. 

Toronto 10, Canada 



JANUARY. 1959 • Vol. 55, No. 1 



Surgery was not a mystery to the 
Indian. He performed amputations at 
the joints with a knife of flint or 
jasper, then seared spouting vessels 
with stones heated to redness and 
thus arrested hemorrhage. 

The Indian's system of medicine, 
surprisingly complete, was an unwrit- 
ten one and one that was handed down 
from generation to generation. The 
care of the sick was placed in the 
hands of the women of the tribe who 
were thus the first nurses on this 
continent. 

The Indian's diseases were those 
occasioned by the weather, hardship, 
famine, injury. Diseases of the eye 
were common due to prolonged irrita- 
tion from the smoke in their lodges 
or teepees where a hole in the roof 
took the place of a chimney. 



The arrival of the white man brought 
to the Indian new and unknown dis- 
eases that swept through his tribe like 
a devastating flame. Only then did his 
system of medicine break down. 

Although the Indian population was 
severely decimated, today the medical 
marvels of the pale face have stemmed 
the tide and the Indian population is 
gradually increasing. Health services 
are administered by the Department 
of National Health and Welfare. In 
1953, 20 hospitals, 42 nursing stations 
and 61 other health centres were oper- 
ated by the Department to serve both 
the Indians and the Eskimos. Full- 
time departmental medical officers are 
assigned to the larger Indian reserves 
with part-time officers responsible for 
the health of the smaller Ijands. 



A Silver Anniversary 



THE University of Toronto School of 
Nursing celebrated its 25th Anniversary 
with a very successful "Open House" at the 
School of Nursing, 50 St. George Street, on 
October 17, 18 and 19, 1958. Many alumnae 
and friends of the school took this opportun- 
ity to renew acquaintances and to tour the 
new building, opened in 1953. 

One of the highlights of the celebration 
was the opening of regular classes to 
alumnae, high school students and the 
general public. These classes, from the basic 
and post-basic curricula, were of the lecture, 
seminar and demonstration types. Professor 
Margaret McPhedran and Miss Margaret 
MacLachlan lectured to the public health 
general students ; Professor Jeannette Wat- 
son to the nursing education and nursing 
service groups, and Professor Muriel Upri- 
chard gave a lecture on the problems of 
education. Professor Jean Wilson and Mrs. 
Carol Brehaut conducted nursing demon- 
stration classes for the two junior years 
of the basic course. Miss Jeannetta Mac- 
Phail gave a lecture in obstetrics. Professors 
Mary Millman and Helen Carpenter con- 
ducted seminars with the fourth year basic 
students. Professor Millman's seminar in- 
cluded in its content a demonstration of 
using a tape recorder as a teaching method. 

All of these classes were very well at- 
tended. A great deal of interest was shown 
by the high school students. Particularly 



well-received was a special "Symposium on 
Nursing Research" held in Cody Hall, the 
spacious auditorium of the school. Professor 
Nettie Fidler, director of the school, intro- 
duced the symposium. Professors Carpenter 
and Uprichard and Miss Margaret Allemang 
took part. 

The focal point of the Open House con- 
sisted of 33 displays in Cody Hall, repre- 
sentative of the work and activities of the 
school and its 3450 graduates. The material 
in each display was both interesting and in- 
structive and the general effect, aided by 
large flags of the countries represented, 
was quite impressive. A special feature which 
added considerably to the enjoyment of the 
guests was the provision by the alumnae 
association of refreshments for all. 

Included among our many visitors were 
the following graduates of the various 
courses offered by the School : Misses 
Margaret McKenzie and Mary Pae, who are 
in India with WHO ; Miss Gertrude Swaby, 
public health nursing in Jamaica; Miss 
Jamila Ahmed of Pakistan ; Miss Alma Reid, 
director of the School of Nursing, McMaster 
University; Miss Ethel Gordon, Chief Super- 
visor of Nursing Counsellors of the Civil 
Health Services Division, Department of 
National Health and Welfare; Miss Heather 
McDonald, Nursing Consultant, Indian and 
Northern Health Services. Another welcome 
visitor was Miss Anne Moore, of the 



48 



THE CANADIAN NURSE 



YESTERDAY, a COUGH SPOILED HIS DRAWING 
1^ _--- TODAY MIS COUGH IS UNDER CONTROL WITH 

B^mm ^k ■ m^r ■ ■ |^H® benylin expectorant with codeine 
V!* 1^1 ^W ^^^ ■ 1^1 contains each fiuidounce: 

^m^-^^^^-rr^^M^IT Codeine phosphate 1/3 gr. 

■l.*i»."i&*^ I \^W%gAW^ I Benadryl* hydrochloride 

WITH CODEINE (diphenhydramine hydrochloride, 

Parke-Davis) 80 mg. 

Ammonium chloride 12 gr. 

Sodium citrate 5 gr. 

Chloroform 2 j 

Menthol 1/10 gr. 

supplied: BENYLIN EXPECTORANT WITH 
CODEINE is available in 4-oz., 8-oz., and 
■ '/2-gallon bottles. 

^ Also available: BENYLIN EXPECTORANT (without 

codeine) in 4-02., 8-oz., 16-oz., and '-i-gallon bottles. 

^PARKE, DAVIS A CO., LTD. 
MONTREAL 2, QUEBEC 




JANUARY. 1959 • Vol. 53, No. 1 



49 



Colombo Plan Administration in Canada. 
Among our local visitors were the President 
and Vice-President of the University and 
many other members of the University staff. 
We were also delighted to welcome directors 
of nursing, staff members and students from 
hospital school of nursing and from public 
health agencies in Toronto. 

Telegrams and congratulatory letters, 
many describing the work of the writers, 
were received with much appreciation. These 
came from as far away as Jugoslavia (Miss 
Dina Urbancic, Nursing Education 1949), 
Poland (Mrs. Jadwiga Izyeka Kaniewska, 
Nursing Education 1935), Denmark, (Miss 
Karen Jacobsen, Advanced Nursing 1940), 
Sweden (Miss Ruth Abrahamsen, Public 
Health Nursing Advanced 1953), Costa 
Rica (Miss Alicia Montealegre, Clinical 



Supervision 1954) and India (Mr, Jesudoss 
Sigamoney, Nursing Education 1955). 

The tea given on Sunday afternoon by the 
alumnae association was the concluding event 
of the three-day celebration. It was attended 
by over 400 alumnae and friends. Miss Fidler 
and Miss Myrna Clark, president of the 
alumnae association, received the guests. 
Past presidents of the association acted as 
hostesses. Miss Kathleen Russell and Miss 
Florence Emory both attended and seemed 
to enjoy themselves thoroughly. A brief 
ceremony highlighted the tea when Miss 
Fidler, aided by one of our earliest gradu- 
ates, Mrs. Josephine Clissold (Public Health 
Nursing 1923) and one of our most recent 
graduates. Miss Nancy Clark (B.Sc.N. 
1958) took part in cutting the anniversary 
cake. 



Strokes need not originate within the 
brain, as is commonly believed, and in many 
cases can be effectively treated through sur- 
gery outside the brain. In as many as one- 
fourth of those who suffer strokes, the 
brain's blood supply may be blocked by clots 
forming in vessels at points before they enter 
the brain itself. This circumstance makes 
it possible to remove or bypass the blockage 



and restore normal circulation to the brain. 
X-ray studies of arteries have shown that 
the obstruction is often located in an artery 
of the neck or upper torso. In such cases 
it may be possible to apply surgical pro- 
cedures similar to those through which cir- 
culatory deficiencies in the arms, legs and 
elsewhere have been successfully treated. 

— .American Heart Association 



1958 INDEX 



SUBSCRIBERS WISHING TO RECEIVE COPIES OF THE 

i95S Ond^a, 

ARE REQUESTED TO COMPLETE THIS COUPON AND 

MAIL IT TO 

THE CANADIAN NURSE 

1522 Sherbrooke St. West 
MONTREAL 25, QUEBEC 

Please print all details. 
Name 



Street 



City 

Number of copies desired 



Zone No. 



ProN 



DO 



THE CANADIAN NURSE 





Our Navy 
Needs Your 



Nursing Skill 





CN-5-57 



A Naval Nurse Is an important nurse — caring for the health of 

Canada's fighting sailors. 

She leads on eventful life — with opportunities to engage in special 
fields, both medical and surgical and others — to travel — to serve 
her country — to enjoy the status and privileges of an Officer in 
Canada's senior service. 

Our expanding Navy has operungs now in its Nursing 
Service — for provincially-registered graduate nurses who 
are Canadian citizens or British subjects, single and under 
35 years of age. 

Apply today! Upon entry you will be offered a permanent or short 
service commission with officer pay, allowance for uniforms, full 
maintenance and other benefits including 30 days annual leave with 
pay and full medical and dental care. 

As a Naval Nurse, you'll find real opportunity to advance in your 
profession! For full information apply to: 

MATRON-IN-CHIEF, 

NAVAL HEADQUARTERS, OTTAWA 

or 

YOUR NEAREST NAVAL RECRUITING OFFICE 



Royal Canadian Navy 



JANUARY, 1959 • Vol. 55. No. 1 



SI 




NURSING 

across the 

^NATION 



PREPARED IN YOUR NATIONAL OFFICE, CANADIAN NURSES' ASSOCIATION, OiTAVVA 



A Report of the I.L.O. Ad Hoc 
Committee 

The CNA Nursing Secretary, F. 
Lillian Campion was invited by the 
International Labor Organization to 
represent Canada as a member of the 
Ad Hoc Committee on "Conditions 
of Work and Employment of Nurses." 
The meeting was held at the I.L.O. 
Headquarters in Geneva from October 
6 to 11, 1958. 

At the opening session, Miss Cam- 
pion was named chairman and so had 
the privilege and responsibility of 
presiding over the week-long meeting. 

Because of the interest in this 
significant international gathering, we 
are devoting this column to a summary 
report prepared by Miss Campion. 

The I.L.O. 

The I.L.O. is an agency of 70 
governments united to work for lasting 
peace based on social justice. It deals 
with international labor and social 
problems, much as the UN Food 
and Agricultural Organization handles 
questions relating to the earth's food 
supply and the World Health Organiz- 
ation works to improve the health of 
the people living on this planet. 

The I.L.O. is "tripartite." Each 
member country sends two government 
delegates, one employer and one worker 
to the I.L.O.'s Annual International 
Labor Conference. 

The International Labor Office at 
Geneva, Switzerland is situated in a 
park on the banks of Lake Geneva, 
not far from the Palais des Nations. 
About 700 officials of 57 nationalities 
conduct a year round program of 
international action to raise living and 
working standards. They do the re- 



search and prepare the reports which 
are discussed at the I.L.O. conferences 
and meetings in all parts of the world. 

W.H.O. and I.L.O. 

Some years ago, a W.H.O. Expert 
Committee on Nursing drew attention 
to the close link between the recruit- 
ment of candidates for nursing and the 
working and living conditions of 
nurses. They urged W.H.O. to invite 
the cooperation of I.L.O. in a joint 
investigation of the working conditions 
of nursing personnel including salaries, 
hours of work, health conditions and 
personnel policies. Other interested 
groups have since urged similar in- 
vestigations. 

Study of Conditions of Work 

The Director General of the I.L.O. 
in 1957 arranged for a comparative 
study of the employment and conditions 
of work of nurses and agreed to con- 
vene an ad hoc 'meeting of experts to 
consider the results. The report of the 
study was the basis of the Committee's 
discussions. Miss Margrethe Kruse, 
Executive Secretary, Danish Council 
of Nurses and Chairman of the Com- 
mittee on Exchange Privileges for 
Nurses, I.C.N., a professional nurse 
of wide experience, was appointed by 
the I.L.O. after consultation with W. 
H.O. to assist in the comparative study- 
The report was prepared on the basis 
of replies to a questionnaire circulat- 
ed by the International Council of 
Nurses, the International Committee 
of Catholic Nurses and Social Workers, 
and the International Federation of 
Unions of Employees and Public and 
Civil Services to affiliated organiz- 
ations in 67 countries. 



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JANUARY, 1959 • Vol. 55, No. 1 



53 



The material contained in the report, 
covering 54 countries in all parts of the 
world, as is stated in the introduction, 
necessarily conceals wide variations in 
political and economic and social back- 
grounds, traditions and conditions. 

A d Hoc Meeting 

The meeting was opened by Luis 
Alvarado, Assistant Director-General 
of the I.L.O. who spoke on behalf of 
the Director-General, David A. Morse. 
Ambassador Julio A. Barboza-Carneiro 
of Brazil, Chairman of the Governing 
Body of the LL.O. was also present at 
the opening meeting. 

The study and the meeting were 
under the direction of the Women's 
and Young Workers' Division of the 
I.L.O. Mrs. Ana Figueroa, Chief, the 
Women's and Young Workers' Di- 
vision was responsible for the vast 
amount of planning, organization and 
direction necessary for the comparative 
study and the Ad Hoc Committee 
meeting. This, together with her assist- 
ance during the deliberations, contri- 
buted greatly to the success of the 
meeting. 

The members of the Committee re- 
presented 14 countries including Aus- 
tria. Brazil, Canada, Chile, France. 
India, Japan, Liberia, Philippines, 
Sweden, Turkey, United Kingdom. 
U.S.S.R. and U.S.A. Mrs. Janet 
Buckle, President of the Liberian Na- 
tional Nurses' Association was elected 
\icc-chairman and Miss Julita Sotejo. 
Dean of the School of Nurses, Uni- 
versity of the Philippines, reporter. 

Simultaneous translation was avail- 
able in four languages, Spanish, Ger- 
man, French and English. The member 
from Russia was accompanied by a 
translator who translated into English 
as the delegate spoke. 

Observers 

In addition to the nurse members of 
the Committee, several inter-govern- 
mental and non-governmental organiz- 
ations were represented by observers. 
Included were the World Health 
Organization, the Council of Europe, 
International Committee of Catholic 
Nurses, International Committee of the 
Red Cross, International Council of 
Nurses, the International Federation 



of Christian Trade Unions. Employee 
of Public Services and P.T.T.N., Th< 
International Federations of Unions o 
Employees of Public and Civil Service 
the League of Red Cross Societies, tht 
World Federation of Trade Union: 
and the World Medical Association 
These observers had the privilege o 
speaking once to each of the four item; 
on the agenda. 

Topics of Discussion 

The first four days were spent ir 
discussion of the four items of the 
agenda which had been approved b> 
the go\erning body of the I.L.O. These 
were : 

Eiiiployniciit Situation — 
Shortage of nurses ; influence of 
marriage on employment ; part-time 
employment. 

Conditions of Work — 
Contract of employment ; remuner- 
ation ; social security. 

Economic and Social Status — 
Professional nurses; auxiliary per- 
sonnel. 

Recruitment including counselling and 
placement services. 

Recommendations 

The very able Secretariat of the 
Division was invaluable in recording 
the discussions, abstracting the salient 
points and recommendations, prepar- 
ing a draft report for the final con- 
sideration of the committee. Included 
in the recommendations were : 

That more complete, reliable and 
detailed statistical information be collect- 
ed as a basis for relating the supply of 
nurses to the demand for nursing 
services. 

That the prevalent shortage of pm- 
ic=sional nurses, characteristic of most 
countries and acute in many, should be 
overcome by planned policies aimed at 
more effective utilization and retention 
of available nursing resources. 

That in view of the importance of 
joint consultation in determining condi- 
tions of work, machinery for negotiating 
terms and conditions of employment 
should be set up in every coui.try where 
it does not now exist. Nursing personnel, 
through organizations of their choice, 
should be associated directly in its oper- 
ation. 

That in order to meet the special re- 



54 



THE CANADIAN NURSE 



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55 



quirements of nursing service, and to 
avoid fatigue for nursing personnel, 
hours of work should not exceed an 
average of 40 per week, that strict limits 
should be placed on the working of over- 
time within any given work period and 
that weekly rest should be uninterrupted 
and should be not less than 36 con- 
secutive hours. 

That remuneration for nursing per- 
sonnel, should be raised to a level 
commensurate with their education, qua- 
lifications, responsibilities and duties. 
Salary scales should be calculated on the 
basis of job analysis and evaluation and 



the principle of equal remuneration for 
men and women for work of equal value 
should be adopted. 

That adequate opportunities should be 
provided for professional development 
and advancement through such measures 
as specialized post-basic education, study 
and fellowships, security of tenure and 
safeguard of privileges on transfer. 

That recruitment programs should be 
planned on a long-term basis in relation 
to the demand for nursing service and 
skills and should be based on facts 
regarding conditions and needs of all 
branches of the nursing service. 



^e ttc<^^^^ <i t^atAcn.^ Ce frcuf^^ 



Rapport d'un Comite special de I'O.I.T. 

La secretaire de la Section du Nursing, 
Mile F. Lillian Campion, fut invitee par 
['Organisation Internationale du Travail a 
representor le Canada aupres du Comite 
specialement forme pour etudier "les condi- 
tions de tfravail et d'emploi chez les infir- 
mieres." La reunion eut lieu aux quartiers 
generaux de I'O.LT., a Geneve, du 6 au 11 
octobre 1958. 

A la seance d'ouverture, Mile Campion fut 
nommee presidente, honneur qui lui donna le 
privilege et la responsabilite de presider 
les assises durant une semaine. 

Vu I'importance de cette reunion interna- 
tionale, toute cette chronique sera consacree 
au rapport prepare par Mile Campion. 

L'Organisation Internationale du Travail 

L'O.LT. comprend 70 pays unis pour 
travailler a I'obtention d'une paix durable, 
basee sur la justice sociale. C'est un orga- 
nisme qui s'occupe des questions de travail 
et des problemes sociaux tout comme I'Orga- 
nisation Mondiale de la Sante s'occupe de 
I'amelioration de la sante des habitants 
de cette planete. 

L'O.LT. est "tripartite." Chaque pays 
membre y est reiiresente par deux delegues 
de son gouvernement, un employeur et un 
travailleur, a la Conference Annuelle de 
I'O.LT. 

Le Bureau a Geneve, Suisse, est situe dans 
un pare sur les bords du lac Geneve, non 
loin du Palais des Nations. Environ 700 



personnes de 57 nationalites y travaillent de 
facon permanente a la realisation d'un pro- 
gramme de portee Internationale visant a 
elever le niveau de vie et de travail. On y 
fait de la recherche et Ton redige des rap- 
ports qui sont discutes au cours des confe- 
rences et reunions de I'O.LT. dans toutes 
les parties du monde. 

L'O.MS. et I'O.I.T. 

II y a quelques annees, un Comite d'ex- 
perts en Nursing de I'O.M.S. attira I'atten- 
tion .sur la relation etroite qui existe entre 
le recrutement des candidates infirmieres et 
les conditions de vie des infirmieres. Le 
Comite insista pour que I'O.M.S. sollicite 
la collaboration de I'O.I.T. dans une etude 
conjointe des conditions de travail chez les 
infirmieres : salaircs, heures de travail, con- 
ditions sanitaires, lignes de conduite, etc. 
Depuis ce temps d'autres groupes firent 
la meme demande. 

Etude sur les conditions de travail 

Le directeur general de I'O.I.T. prepara 
une etude comparative sur les conditions 
d'emploi et de travail chez les infirmieres 
et decida d'en soumettre les resultats a 
un comite ad hoc d'experts qui en etudia et 
en discuta le rapport. Mile Margrethe 
Kruse, secretaire du Conseil des Infirmieres 
du Danemark et presidente du Comite 
d'Echange entre membres du C.I.I., fut 
choisie par I'O.I.T.. apres consultation avec 
I'O.M.S., pour collaborer a cette etude com- 



56 



THE CANADIAN NURSE 




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JANUARY, 1959 • Vol. 55, No. 1 



57 



parative. Le rapport de cette etude a ete re- 
dige d'apres les reponses a un questionnaire 
envoye par I'intermediaire du Conseil Inter- 
national des Infirmieres, du Comite Interna- 
tional des Infirmieres catholiques et des Tra- 
vailleurs sociaux et de la Federation Inter- 
nationale des Unions d'employes ainsi que 
des Services publics et civils, a des organisa- 
tions connexes dans 67 pays. 

Le materiel de ce rapport couvrant 54 pays 
de toutes les parties du monde revela une 
grande variete dans les idees politiques, 
economiques et sociales dans les traditions 
et les conditions de vie et de travail. 

Assemblee ad hoc 

L'assemblee fut ouverte par Luis Alvarado, 
directeur-general adjoint de I'O.I.T. qui 
parla au nom du directeur-general, David A. 
Morse. L'ambassadeur Julio A. Barboza- 
Carneiro du Bresil, president du Bureau 
de direction de I'O.I.T. etait aussi present 
a la seance d'ouverture. 

L'etude et l'assemblee etaient sous la direc- 
tion de la Division des Femmes et Jeunes 
Travailleurs de I'O.I.T. C'est Mme Ana 
Figfueroa, chef de cette division qui assuma 
la vaste tache de I'organisation et de la 
direction de l'etude comparative et du comite 
special. Ce travail et sa presence aux debats 
contribuerent grandement au succes de cette 
reunion. 

Les membres du Comite representaient 14 
pays : I'Autriche, le Bresil, le Canada, le 
Chili, la France, I'lnde, le Japon, le Liberia, 
les Philippines, la Suede, la Turquie, le 
Royaume-Uni, I'U.R.S.S. et les Etats-Unis. 
Mme Janet Buckle, presidente de I'Associa- 
tion nationale des Infirmieres du Liberia, 
fut elue vice-presidente et Mile Julita Sotejo, 
Principale de I'Ecole d'Infirmieres de I'Uni- 
versite des Philippines, fut nommee rappor- 
teur. 

La traduction simultanee fut faite en quatre 
langues : I'espagnol. I'allemand, le francais et 
I'anglais. La representante de la Russie etait 
accompagnee d'un traducteur qui traduisait 
en anglais ce qu'elle disait en russe. 

Observateurs 

En plus des infirmieres membres du Comi- 
te, plusieurs organismes gouvernementaux et 
autres etaient representes par des observa- 
teurs. Etaient ainsi representes : I'Organisa- 
tion Mondiale de la Sante, le Conseil d'Eu- 
rope, le Comite International des Infirmieres 
Catholiques, le Comite International de la 
Croix-Rouge, le Conseil International des 



Infirmieres, la Federation Internationale des 
Unions Ouvrieres Chretiennes, les Employes 
de Services Publics et P.T.T.N., la Fede- 
ration Internationale des Unions d'employes 
de services publics et civils, la Ligue des 
Societes de la Coix-Rouge, la Federation 
Mondiale des Unions Ouvrieres et I'Asso- 
ciation medicale Mondiale. Ces observateurs 
eurent le privilege de parler une fois sur 
chacun des quatre sujets au programme. 

Sujets de la discussion 

Les quatre premiers jours furent consacres 
a la discussion des quatre questions inscrites 
a I'ordre du jour, prealablement approuv^s 
par le Bureau de direction de I'O.I.T., savoir : 

Situation de I'emploi — Penurie d'infir- 
mieres ; influence du mariage sur I'emploi ; 
le travail a temps partiel. 

Conditions de travail — Contrat d'emploi ; 
remuneration, securite sociale. 

Statut social et economique — Infirmieres 
professionnelles, personnel auxiliaire. 

Recrutement comprenant services d'orien- 
tation et de placement. 

Recommandations 

Le personnel du secretariat de la Division 
a pris les deliberations avec toute la com- 
petence qui le caracterise, a fait un resum^ 
des points saillants des recommandations et 
a redige un rapport final pour etre soumis au 
Comite. Parmi ces recommandations nous 
notons les suivantes : 

Que des renseignements statisti(iues plus 
complets, plus siirs et plus detailles soient 
compiles pour servir de base a I'etablisse- 
ment de comparaisons entre I'ofi^re et la de- 
mande des services d'infirmieres. 

Que Ton remedie a la penurie d'infirmieres 
professionnelles existant dans la nlupart des 
pays et a I'etat aigu dans plusieurs, par I'eta- 
blissement d'une ligne de conduite visant une 
utilisation plus efficace ainsi qu'a la conserva- 
tion des ressources disponibles dans le do- 
maine du nursing. 

Qu'en vue de I'importaiice d'une consul- 
tation mutuelle dans la determination des 
conditions du travail, un organisme servant 
a determiner les conditions d'emploi et les 
traitements devrait ctre etabli dans les pays 
oil cela n'existe pas. Les infirmieres, par 
I'intermediaire d'organisations de leur choix. 
devraient etre directement associes a son 
fonctionnement. 

Qu'afin de repondre aux exigences parti- 
culieres du soin des malades et d'eviter la 
fatigue chez les membres du personnel soi- 
gnant, les heures de travail devraient etre 
fixees de facon que les heures supplemen- 



58 



THE CANADIAN NURSE 




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taires de travail soient judicieusement repar- 
ties et que le repos hebdomadaire ne soit pas 
interrompu pendant au moins 36 heures. 

Que la remuneration des infirmieres soit 
proportionnee a leur instruction, leur pre- 
paration, leurs responsabilites et leurs fonc- 
tions. La bareme des salaires doit etre 
calcule en se basant sur I'analyse et reva- 
luation des taches, en respectant le principe 
du salaire egal a travail egal, pour les 
hommes et les femmes. 



Que Ton favorise le developpement et 
I'avancement de la profession par I'etablis- 
sement de cours post-scolaires, etudes, bour- 
ses, assurance de la stabilite de I'emploi et 
transfert des privileges acquis lorsqu'une 
infirmiere change d'employeur. 

Que les programmes de recrutement soient 
a longue portee, tenant compte de la de- 
mande, et bases sur des faits etablis selon 
les besoins et les conditions de toutes les 
differentes branches du nursing. 



Victorian Order of Morses 



The following is a list of recent staff 
changes in the Victorian Order of Nurses 
for Canada. 

Appointments — Theresa Bergeron (St. 
Vincent de Paul Hosp., Sherbrooke, P.Q.) 
to Edmunston, N.B. Mary Bradley (Univ. of 
Ottawa) to Bathurst, N.B. Barbara Brannan 
(Saint John Gen. Hosp.) to Saint John. 
Shelby Bouthiller (Misericordia Gen. Hosp. 
Winnipeg) to Winnipeg. Patricia Cave 
(Grace Hosp., Windsor) to Windsor. Mavis 
Chittick (Yale Univ. S. of N., New Haven) 
to Calgary. Beverley Copithorne (Vancouver 
Gen. Hosp.) to Vancouver. Mrs. Olga Coyes 
(Saskatoon City Hosp.) to Edmonton. 
Judith F. Davis (Royal Jubilee Hosp., 
Victoria) to Montreal. Joyce Dickey (Vic. 
Hosp., London) to Digby, N.S. Audrey 
Drennan (Mack Training School for Nurses, 
St. Catharines) to Owen Sound. Susan Geml 
(Hotel Dieu, Windsor) to Windsor. Ruther 
Mary Gtvilliam (Hope Hosp., Salford, Lan- 
cashire) to Greater Montreal. Emilia Hagel 
(St. Michael's Hosp., Lethbridge) to Carle- 
ton Place, Ont. Ruth Hayden (Univ. of 
B.C-) to Halifax. Ruby Henrickson (Win- 
nipeg Gen. Hosp.) to Winnipeg. Merilyn 
Ethel Hood (Vic. Hosp., London) to Mont- 
real. Elisabeth Ann-e Hutchinson (V.G.H.) 
to Victoria. Carol Irvine (Hamilton Gen. 
Hosp.) to London. Esther Janzow (Royal 
Columbian Hosp. New Westminster) to 
Victoria. Georgina Johnson (Grace Hosp., 
Winnipeg) to Winnipeg. Patricia Ann 
Lauerner (U.B.C.) to Vancouver. Olive 
Legge (Moose Jaw Union Hosp.) to Van- 
couver. Donna McDougall (Kingston Gen. 
Hosp.) to Smiths Falls. Mrs. Mary Mc- 
Evoy (Royal Vic. Hosp., Montreal) to 
Montreal. Mrs. Beverly Mclntyre (Univ. 
of Toronto S. of N.) to Toronto. Mrs. 
Barbara Ann McWilliams (V.G.H.) to 
Vancouver. Halley Anne MacBain (H.G.H.) 
to Hamilton. Patricia Ann Madley (U.B.C.) 



to Vancouver. Mary Patricia Malloy (V.G. 
H.) to Vancouver. Sheila Meiteen (Jewish 
Gen. Hosp., Montreal) to York Township. 
Gwendolyn Miller (Metropolitan Hosp., 
Windsor) to Cobalt-Coleman. Barbara Mills 
(Moncton Hosp., N.B.) to Moncton. Sheila 
Murray (V.G.H.) to Wolfville, N.S. Janet 
Penney (Grace Hosp., Halifax) to Pictou, 
N.S. Katie Peters (V.G.H.) to Trail, B.C. 
Dorothy Philips (Montreal Gen. Hosp.) to 
Arnprior. Noreen Phillpot (MacMaster 
Univ. S. of N.) to Burlington, Ont. Mrs. 
Gaye Donna Pilling (MacMaster Univ. S. 
of N.) to Montreal. Mrs. Cynthia Poivell 
(V.G.H.) to Winnipeg. Shirley Receveur 
(Holy Family Hosp., Prince Albert) to 
Prince Albert. Mrs. Mary Richardson (Vic- 
toria Hosp., London) to Toronto. Elaine 
Marina Rose (Toronto Gen. Hosp.) to 
Guelph. Mrs. Gaye Ross (V.G.H.) to Bur- 
naby. Olga Smucsok (Grace Hosp., Wind- 
sor) to Windsor. Mrs. Gloria Tufford 
(Moose Jaw Union Hosp.) to Ottawa. 
Maria Vandenijssel (Vronstein Park Vron- 
steil, Voorburg, Holland) to Montreal. Myra 
Ellen Warren (Calgary Gen. Hosp.) to 
Greater Niagara. Mary Dawn Webster 
McMaster Univ. S. of N.) to Hamilton. 
Gertrude Woelders (Diaconessenhuis, Haale, 
Holland) to Halifax. 

Transfers — Lola Baft, Mrs. Alma Met- 
calfe to Montreal. Patricia Copley to North 
Vancouver. Donna Hackman to Prince 
Albert. Beatrice M. Hunt to Ottawa. Win- 
nifred James to North York. Marie Kos- 
sowka to LaSalle, P.Q. Ada McEwen, Ethel 
Shaw, to National Office. Elizabeth Mac- 
Kensie to Saint John, N.B. F. Blanche 
MacPherson to St. John's, Nfld. May Louise 
Shaffner, Elisabeth Smith to Vancouver. 
Margaret Standerivlck to Lethbridge. Maria 
Van Noort to Edmonton. Margaret Warren 
to Sarnia. Lily Watanabe to York Township. 



60 



THE CANADIAN NURSE 



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JANUARY, 1959 • Vol. 55, No. 1 



61 



International Essay I'onipetition 



The International Council of Nurses, 
through its Ethics of Nursing Committee, 
announces an international essay competition 
in which Graduate Nurses of all national 
member associations in membership with the 
ICN are invited to take part. 

The competition is designed to reach in- 
dividual members in the nursing field and to 
increase their awareness of the meaning and 
significance of nursing ethics. 

For more than half a century, at the 
closing session of each International Con- 
gress, the retiring President has given a 
"Watchword" for the next four-year period. 
This has become a valued tradition for as 
one President, the late Baroness Sophie 
Mannerheim, has said : "Words are not 
always solely words. Sometimes a word can 
l)e engraved on our hearts and be as a guide 
for our work." 

The subject of the essay is to be either : 

1. One of the watchwords given by an 
ICN President, or 

2. The International Code of Nursing 
Ethics, how it could be brought into nursing 
schools and ways and means of integrating 
teaching so that ethics may be included in 
all nursing subjects. 

The watchwords are as follows : 
1901— BuflFalc^-Mrs. E. Bedford Fenwick 

—Work 
1904— Berlin— Mrs. E. Bedford Fenwick 

— Courage 
1909 — London — Mrs. E. Bedford Fenwick 

—Life 
1912 — Cologne — Schwester Agnes Karll 

— Aspiration 
1925 — Helsinki — Baroness Sophie Manner- 
heim — Peace 
1933— Paris, Brussels— Mile L. Chaptal 

— Concord 
1937 — London — Dame Alicia Lloyd Still 

— Loyalty 
1947— Atlantic City— Miss Efifie Taylor 

— Faith 
1953 — Petropolis — Miss Gerda Hojer 

— Responsibilit \ 
1957— Rome— Mlle'Marie M. Bihet 

— Wisdom 

Conditions of Entry 

1. The competition is open to graduate 
nurses who are members of ICN member 
associations. If any question arises as to the 
eligibility of a contributor, the decision of 
the panel of judges shall be final. 



2. The Essay shall be typewritten on one 
side of the paper only and shall be approxi- 
mately 2,000 to 3,000 words. 

3. Each entry must be signed by a "pen- 
name." The name and address of the con- 
tributor must be enclosed in a sealed enve- 
lope and attached to the manuscript. 

4. The essay must be forwarded to the 
national Nurses' Association of the country 
concerned. 

5. National Nurses' Associations have 
kindly undertaken to assist the Ethics of 
Nursing Committee in the following ways : 

(a) To receive completed essays. 

(b) To judge essays nationally by a Na- 
tional judges' panel. 

(c) To translate the winning essays into 
English (if necessary) and forward 
them to the Headquarters of the Inter- 
national Council of Nurses. 

The closing date for Canadian entries will 
be May 15, 1959. 

National Nurses' Associations will forward 
not later than September 1,1959, five copies 
of each of the two winning essays on a 
Watchword or the International Code of 
Nursing Ethics, or if one subject only has 
been selected, five copies of the winning 
essay only. 

6. A prize will be awarded for the winning 
essay (in each of the two subjects if both 
are selected by the National Associations). 
Credit will be given in the case of those 
essays which give evidence of a knowledge 
and appreciation of fundamental ethical prin- 
ciples. 

7. The winning essays will be published in 
The International Nursing Reznew. No entry 
may be sent which has previously appeared 
in print. 

8. No essay submitted may be published 
in any nursing journal or in any other form 
without the permission of the International 
Council of Nurses. Essays will be returned 
to the writers after the results of the com- 
petition have been announced. For this 
purpose a self-addressed envelope should be 
enclosed with the original material, and the 
cost of postage refunded. 

9. The International Judges' Panel will 
consist of five members : — 

The General Secretary, ICN. 

The Editor, The International Nursing 
Review. 

The chairman and two other members of 
the Ethics of Nursing Committee. 



The antibiotic drugs and the development 
of the powerful new operating microscopes 
have enabled the ear surgeon to safely per- 
form operations on delicate middle ear struc- 
tures, previously impossible. They have also 
helped us to find out a great deal more of 
tlie effect of middle ear disease on hearing 
so that attention has been directed to the 
developing of new operations to restore dam- 



aged hearing function. This has opened up 
a whole new field in ear surgery and 
promises great benefit to all those who are 
suffering from middle ear deafness. 

— G. Alexander Fee, M.D. 

Blessed are the forgetful ; for they get the 
better even of their blunders. 

— Friedrich Wilhelm Nietzsche 



62 



THE CANADIAN NURSE 




Hollister ldent'A'Band%he original 

the positive all-patient, on-patient identification 

Just a glance ... a short "pause for patient identification." But a 
long step away from medication-errors. In hospital after hospital, the 
risk of liability due to errors went down when Ident-A-Band went in. 
Only Ident-A-Band is sealed , . . sealed so sure that the band must be 
destroyed to remove it. 

Your hospital name is prmted on each Ident-A-Band, and the insert 
card has ample space for all the identification data you may want to in- 
clude. And it slips easily into the non-irritating, skin-soft band. The 
supple softness and custom-fit assure patients that you are thinking of their 
comfort as well as their safety. Write for free samples and information. 



JfoLListeB^ 



FRANKLIN C HOLLISTER COMPANY 
833 N.ORLEANS ST. + CHICAGO 10, ILLINOIS 



JANUARY, 1959 • Vol. 55, No. 1 



63 



Ontario 



The following is the list of changes in the 
Ontario Public Health Services. 

Appointments — Olga Roman (Royal 
Vic. Hosp., Montreal, Univ. of Toronto) and 
Dorothy Lee Chishohn (R.V.H., Montreal, 
McGill Univ.) to Belleville Board of Health. 
Ruth Tackaberry (Western Hosp., Toronto, 
Univ. of West. Ont.), Gzvcndolyn A. Hud- 
son (Ottawa Civic Hosp., U.W.O.) and 
Margaret Farrell (St. Jos. Hosp., London, 
U.W.O.) to E!gin-St. Thomas Health Unit. 
Alda G. Ruthven (Guelph Gen. Hosp., U. of 
T.), Mary-Ellen MacDonald (St. Mary's 
Hosp., Timmins, U. of T.), Susie Elisabeth 
Beck (Hosp. for Sick Children, Toronto, 
McGill Univ.) to Elliot Lake Improvement 
District, Ont. Barbara Ross Fleming (H.S. 
C, Toronto, McGill Univ.) and Pauline 
Tomlin (Victoria Hosp., London, U.W.O.) 
to Etobicoke B.H. Marilyn (Dcamudc) 
Hunter (T.G.H., Ont. Hosp., Queen's 
Univ.) to Fort William H.U. Mary Geor- 
gina (Scroggins) Sfever (Vic. Hosp., London, 
U. of T.) to Gait B.H. Ruth Moyer (T.G.H., 
U. of T.) to Guelph B.H. Bertha Reid 
(R.V.H., Montreal, McGill Univ., U. of T.), 
Norma E. O'Shea (St. Jos. Hosp., Kingston, 
Univ. of Ottawa), Ethel Hounslow (Brant- 
ford Gen. Hosp., U. of T.) to Halton Co. 
H.U. Laura Bozven (Kingston Gen. Hosp.. 
U. of T.) to Kingston B.H. Mary Burns 
(St. Jos. Hosp., London, U.W.O.) to Lamb- 
ton H.U. Joan Marie (Cormack) Gibson 
(H.S.C., Toronto, U. of T.) to Muskoka 
H.U. Marion (Johnston-Dickson) Rankin 
(T.G.H., U. of T.) to Northumberland and 
Durham H.U. Henrietta (LaRocque) Find- 
lay (Ottawa Gen. Hosp., Univ of Ottawa), 
Ruth Henry (Brockville Gen. Hosp., U. of 
T.), Mary S. (McCuUoch) Bannerman (T. 
G.H., McGill Univ.), Barbara Ann Gallivan 
(St. Michael's Hosp., U. of T.) and Barbara 
M. McMath (U. of T.) to Peel Co. H.U. 
Joan Dietrich (K.G.H., U.W.O.), Shirley 
Harding and Lorna Harris (Montreal Gen. 
Hosp., U. of T.). Jezvel Killorin (Grey 
Nun's Hosp., Regina, U. of T.), Barbara 
(Mackay) Miller (Dalhousie Univ.), Jane 
O'Loughlin (St. Jos. Hosn., Peterborough, 
U.W.O.) to Peterborough B.H. Lorna 
Nelson (General & Marine Hosp., Owen 



Sound, U. of T.), Margaret Goodes (Hamil- 
ton Gen. Hosp., U. of T.), Grace (Smith) 
Kirkpatrick (H.G.H., U.W.O.) and Noreen 
McQueen (Hotel Dieu Hosp., Moncton, N. 
B., Dalhousie Univ.) to St. Catharines-Lin- 
coln H.U. Dorothy Gibson (St. Jos. Hosp., 
Hamilton, U. of T.) and Joan Royle (Mc- 
Master Univ.) to Sault Ste Marie B.H. 
Joyce Elisabeth Longbottoni (St. Jos. Hosp., 
Toronto, U. of T.) to Scarborough Board of 
Health. Arm P. Blair (Wellesley Hosp., U. 
of T.) and Norah Bradley (St. Michael's 
Hosp., Univ. of Ottawa) to Stormont-Dun- 
das and Glengarry H.U. Helen (Epstein) 
Ghent (McMaster Univ.), Marleen (Lainc) 
Pcntilla (Sudbury Gen. Hosp., U. of T.), 
Lucille Thibault (St. Jos. Hosp., Three 
Rivers, Que. Univ. of Montreal) to Sudbury 
and District H.U. Grace O'Leary (St. Jos. 
Hosp., Sudbury, Univ. of Ottawa) to Sud- 
bury Gen. Hosp., Jean E. Humphrey (T.G. 
H., U. of T.) to Timiskaming H.U. Eliza- 
beth J. P. Davidson (Toronto East Gen. 
Hosp., U. of T.), Barbara Ann (Goddard) 
Pinchhi (Victoria Hosp., London, U.W.O.) 
to Waterloo Township B.H. Mary Ann 
Ladesick (St. Jos. Hosp., Kingston, Univ. 
of Ottawa) to Wentworth Co. H.U. Esther 
V. Matheson (Oshawa Gen. Hosp., U.W.O.) 
to Widdifield B.H. Frances G. Hincks (Ha- 
milton Gen. Hosp., U. of T.) to Weston 
B.H. 

Resignations — Elizabeth Zadanyi and 
Sara Ann (Lambert) Sibay from Haldi- 
niand School Health Service. Lynn (Dobbin) 
Spencer and Anne (Allen) Beckzanth from 
York Co. H.U. Doreen (Mainse) Appleton 
from Lennox and Addington H.U. Alice 
May Lake from Muskoka H.U. Janet 
(Thomson) Reed from Huron Co. H. U. 
Emiliennc Dion, Susanne Tambeau and Alii 
(Huhta) Schatz from Porcupine H.U. Yvette 
Muir from Wellington Co. H.U. Hazel 
Thompson from Waterloo Township B.H. 
Goldie Allen and Jean Ann McWhirter 
from Oshawa B.H. Glcnna (Mozvat) Craig 
and Barbara Jean Nelson from Norfolk Co. 
H.U. Doreen Noonan from Deep River Im- 
provement Dist. Joan Willson and Kathleen 
Barry from St. Catharines-Lincoln H.U. 
Jean (Rorke) Gilliard from Timiskaming 



£4 



THE CANADIAN NURSE 



ke Advantage of the 



EXCEPTIONAL 
PPORTUNITIES 

for REGISTERED NURSES in 

•lAMILTON, CANADA 

resting Work • Excellent Salary • Pleasant Surroundings 



PROGRESSIVE ATTITUDE of the Hamilton General 
aitals offers stimulating work in every field of the 
ing profession. THIS THIRD LARGEST HOSPITAL IN 
•JADA is equipped for the latest and most advanced 
iches of medical science and service. 

ARY FOR REGISTERED NURSES is among the highest 
}ntario. Starting salary ranges from $56.50 to $63.00 
a 40 hour scheduled week. 

IRKING HOURS GIVE AMPLE LEISURE TIME. DAYS 



— normally 7:00 a.m. to 3:30 p.m.; EVENINGS 3:00 p.m. 
to 11:30 p.m.; NIGHTS 11:15 p.m. to 7:15 a.m. These are 
based on 40 hours weekly. Schedules include one half 
hour for each meal. A 15 minute break is given in each 
shift. Eleven paid statutory holidays annually — 3 weeks 
vacation with pay following the qualifying period. 

ACCOMMODATION in the comfortable modern Nurses' 
Residence is available until other suitable living quarters 
are located. 



comp/efe informcrf/on write: The Director of Nursing, Hamilton General Hospital, Barton Street East, Hamilton, Ontario. 

iMILTON is a pleasant place in which to live,.. 




»i : a beautiful city, offering the excite- 

>f e large city ond the warmth of the 

'.Ti unity. 



Situated in Southern Ontario, Hamilton is on Lake 
Ontario close to the U.S.A. border. 



The stimulating pace of Canada is seen 
in this view of Hamilton's main street. 





vacation lands are nearby. This crystal 
mous Muskoka is within o few hours 

travel. 



However you choose to spend your leisure time — 
on the tennis courts or in the art gallery, you'll 
find every facility you could wish for. 



You'll enjoy meeting other girls in your 
chosen profession, sharing your experi- 
ences and broadening your outlook. 



H.U. Arlic (IVriglitJ Lax ton from Algonia 
Tuberculosis Assoc. Frances (Taylor) Jamie- 
son, Beatrice Mair and Joanne (Long) 
GUroy from Halton Co. H.U. Joyce Nevitt 
from Tarentorus Township B.H. Wilhel- 
mena Dtinleavey from Peel Co. H.U. Denise 
(Trcmblay) Bonrgault and Margaret Bergin 



from Ottawa B.H. Norma (Skca) Bingham 
from Kingston B.H. 

Retirements — F. Farr from York Co. 
H.U. IV. Ashplant from Secondary School 
Health Services, Board of Education, London. 
M. Fawcett from B.H.. Hamilton. M. Daley 
from Ottawa B.H. 



Tlie world's population increases 
by one every .83 seconds 
by 50 every minute 
bv 3,000 every hour 



by over 70,000 every 24 hours 

by half a million every week — more tlian 
tiie total of the present populations of 
Halifax, Quebec, Hamilton and Victoria. 



TU^o^ ^Kote^ 



ALBERTA 

Furnishing the new provincial office build- 
ing has become a matter of interest to the 
chapters of the A. A. R.N. Members of the 
Taber group recently donated $10 while 
High River nurses debated the question of 
assisting with this project and increasing 
their membership. There were nine members 
present at a recent meeting. The Peace River 
chapter is investigating the possibility of 
joining with the Grande Prairie unit for a 
joint social or business meeting. In addition 
this chapter is also considering the matter of 
establishing Emergency Housekeeping Ser- 
vices and teaching home nursing. Jasper's 
Edith Cavell chapter has contributed to the 
provincial office fund and made arrangements 
for a course in First Aid for its members. 
It is also hoped that a part time public 
health nurse will be obtained for the com- 
munity. In Hanna, each member donated $1 
towards furnishing the new building. 

Vulcan has decided to continue as a 
chapter with regular monthly meetings being 
held at the homes of the members. A gift of 
$15 was forwarded to the provincial office 
fund. Several members from the Wainwright 
branch were present at the official opening 
of the new office building. The Banff chapter 
donated an electric tea kettle to the Nurses' 
Residence and a fund has been started to 
purchase a television set. Yearly membership 
dues were increased to $2. 



District 2 



PONOKA 



A gift of $100 was sent to provincial office 
to help pay for furnishings in the new- 
building. Latest figures show that the chapter 
has a total of 47 active members. A commit- 
tee arranged for a dance and supper party 
in November as a means of raising funds. 

Members were asked to consider their 
organization in the light of its value to the 
community. It was felt that there should be 
a definite program of activities and a specific 
aim. Several suggestions were made and a 
committee organized to investigate the ques- 



tion of presenting bursaries. Mrs. Margaret 
Newfeldt was a special guest speaker on one 
occasion. She gave a report on the first 
convention held by the Alberta Certified 
Nursing Aide Association. 

District 3 
Calgary 

Forty members attended the supper party 
and annual chapter meeting held at the Holy 
Cross Hospital. Mrs. Duthie gave a brief 
and entertaining report of her attendance 
at the CNA general meeting and presented a 
scrapbook of clippings as a memento. The 
treasurer's report included mention of a 
bursary presented during the summer to 
Carol Osborne, a prospective C.G.H. student. 
Miss Walton-Jones, a visitor from St. 
George's Hospital, London, Eng. outlined 
lier tour of American and Canadian hospitals 
briefly. Miss M. Street spoke about the 
building program at C.G.H. and the furnish- 
ings required. An objective of $700 was set 
to be contributed by the chapter for furnish- 
ing the lounge. 

The new officers for this season are : 
Pres., Mrs. M. Duthie; Vice-Pres., J. 
Cummins ; Sec, D. Green ; Treas., L. 
McComb ; Committees : Institutional, L. 
Bibby; Public Health, G. Broad; Private 
nursing, Mrs. J. Harrison ; Program, D. 
Watrin, K. McLeod; Refreshments, Miss 
Brown, C. Chukaluk; Public Relations, 
F. Moore. 

District 4 
Medicine Hat 

R. Ziehran and D. Schafer described their 
experiences as delegates to the CNA con- 
vention at one of the fall meetings of the 
chapter. They illustrated their report with 
slides, much to the enjoyment of the 22 
members present. Miss Ziehran was the 
convener of the Harvest Tea held during the 
early fall. Inactive nurses are showing a 
lively interest in the refresher course 
planned for them. R. Ziehran has consented 
to teach home nursing to the St. John's 
.Ambulance group. 



66 



THE CANADIAN NURSE 



DrsTRicT 6 
Red Deer 

It was reported at a recent chapter meet- 
ing that 11 appHcations had been forwarded 
to the Bursary Committee — six of the 
applicants being eligible. The lucky reci- 
pient was Pamela Bower and the bursary 
was presented to her at a dinner attended by 
18 members. Mmes Forbes and Sirois are 
conveners for a bake sale to be held as a fund 
raising project. Everyone was pleased to 
learn that meeting rooms are available at 
the Memorial Centre. 

District 7 
Athabaska 

Chapter meetings are under way again for 
the remainder of the year and although the 
group is small, it is enthusiastic. During the 
summer the members supplied First Aid kits 
at three points on the local lakes and were 
gratified to find that they were used and 
appreciated. 

If enough applicants turn up, the Auxil- 
iary of the local hospital plans to sponsor 
a home nursing course. Chapter members 
have offered their assistance. They have also 
helped the Civil Defence organization to 
arrange for a demonstration in the care of 
casualties. 

Jasper 

Mrs. J. Nordgren has been elected presi- 
dent of the Edith Cavell chapter for the 
remainder of its present fiscal year. Eleven 
members were present at a meeting held at 
the home of Mrs. P. Pohlman. 

A letter from Mrs. \'an Dusen described 
the new provincial office and expressed the 
hope that the chapter would assist in fur- 
nishing it. A set of baby scales was donated 
to the hospital by Mrs. Bruce on behalf of 
the chapter. 

District 8 
Lethbridge 

Sister Beatrice and Miss D. Watson re- 
ported on their trip to Ottawa as CNA 
convention delegates at an early fall meeting. 
Sister Beatrice also presented a detailed 
summary of the Canadian Conference on 
Nursing held in Ottawa in 1957. A Civil 
Defence course was held during late Sep- 
tember and received the interested support 
of chapter members. 

Taber 

Miss Alice Reti who entered Lethbridge 
Municipal Hospital last September was pre- 
sented with a cheque for $50 at the Bursary 
Tea held by the chapter members during the 
same month. A display booth at the Family 
Fair in November was used to good advan- 
tage to interest young women of the area in 
nursing. Mrs. Vicol and Mrs. Malo were in 
charge of it. 

A telephone bridge and whist party has 
been planned. The following committee chair- 
men were appointed; Activities, Mrs. D. 
Enman ; Membership, Mrs. B. Rash ; Fi- 
nance, Betty Carnahan; Program, Mrs. B. 
Gibbings ; Lunch, Mrs. D. Dick. 



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Other Tana specialties : Tana White Buck 
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for canvas shoes, and, illustrated below. Tana 
Rapid Shoewhite with tube-top applicator. 

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Shoe Beauty Preparations 



JANUARY, 1959 • Vol. 55, No. 1 



67 




*- 



Jr\ fenainine Ityyiene and tHexapy 




An astringent, soothing vaginal douche, thera- 
peutically valuable in the management of infection 
and as a routine cleansing agent. Its refreshing 
odor appeals to the most fastidious patient. 
Available in 3 and 6 oz. jars. Samples on request. 



FORT ERIE, ONTARIO 



C OTS/1 F=>^rvi>r 



BRITISH COLUMBIA 

COURTENAY 

Thirty-two members attended a meeting 
of the Plateau Chapter held in St. Joseph's 
Hospital, Comox last fall. Three religious 
sisters from Ontario were welcomed into the 
membership and a public health nurse from 
England was a visitor. G. McQuinn attended 
the institute for operating room nurses held 
in Vancouver. Several members represented 
the chapter at the district meeting held at 
Lake Cowichan. Assistance was provided for 
the Red Cross Blood Donor Clinic by 
addressing appointment cards and helping 
on clinic day. G. Skinner was elected to be 
in charge of the Future Nurses' Club for 
local high school students. She hopes to 
arrange a regular program to create interest 
in nursing as a profession. Mrs. W. K. 
Hind attended a Council meeting in Van- 
couver recently. 

Vancouver 

St. Paul's Hospital 

A. T. Scullion has been awarded the 
Vancouver District bursary for use in post- 
graduate education. C. Terry, a graduate of 
last year, is working with the Indian Health 
Department. N. Rumen of the R.C.A.M.C. 
has been doing postgraduate study at the 
Royal Victorian Montreal Maternity Hospi- 
tal. K. Dufton, C. Quan, M. Hildebrant, N. 
Martens and A. Klassen are at U.B.C. this 
year. D. Ritchie and H. Hull completed 
requirement for their certificates in teaching 
and supervision from the same university. 

More than 150 operating room nurses 
attended an institute sponsored by the Regis- 
tered Nurses' Association — the first of its 
kind in this province. Miss G. McFayden, 
supervisor of operating rooms, Shaughnessy 
Hospital directed the institute. Physicians 
and nurses from Vancouver and Victoria 
lectured and demonstrated. Miss E. Prickett, 



assistant professor, University of Pittsburgh 
and consultant in operating room nursing to 
the National League for Nursing, New 
York, also participated. 

Sister Ann Emily has been appointed 
Superior at North Battleford. Helen McLean 
('52) has joined the staff of Huntingdon 
Memorial Hospital, Pasadena. L. (Logan) 
Hill is working as a doctor's' office nurse in 
Cocoa Beach, Florida. Ann Colson ('57) 
has enrolled at the University of Manitoba in 
public health nursing. 

The annual alumnae dance is to be held 
at the Commodore this spring and will be 
shared with the members of the graduating 
class. A fashion show replaced the usual fall 
bazaar last year and members enjoyed the 
new styles displayed by a local dress shop. 
A sale of home cooking, candy and miscel- 
laneous articles helped to increase profits. 



MANITOBA 



Brandon 



General Hospital 

M. Petratz, P. McCunn and Mrs. H. S. 
Perdue reported on the CNA general meet- 
ing as the alumnae association began its 
activities for the fall and winter. Mrs. Per- 
due had taken a number of colored pictures 
and she used these to illustrate her report. 
The annual meeting is to be held in January 
and the new officers will be elected then. 
It was a matter of pride to alumnae members 
and the hospital to learn that Christina M. 
AlacLeod, a graduate and former director of 
nursing, had been among those chosen to 
receive an honorary life membership in the 
M.A.R.N. 

NOVA SCOTIA 

Truro 

Colchester County Hospital 

Mrs. La Verne MacEachern was appoint- 
ed superintendent late last fall. 



68 



THE CANADIAN NURSE 



THE ROOSEVELT HOSPITAL 
APPLICATION FOR APPOINTMENT 

NURSSNG SERVICE DEPARTMENT 




NAME 
ADDRESS 



BIRTHDATE MARITAL STATUS 

WHERE REGISTERED 

CLINICAL SERVICE DESIRED 
POSITION SOUGHT 
DATE AVAILABLE 



EDUCATIONAL BACKGROUND 



SCHOOL OF NURSING ADDRESS DATE OF DIPLOMA OR DEGREE 




















EXPERIENCE (LIST MOST RECENT POSITION FIRST) 


POSITION HOSPITAL LOCATION DATE 











































TRANSPORTATION PAID UPON APPOINTMENT TO STAFF. 

SEND TO: DIRECTOR, NURSING SERVICE 
THE ROOSEVELT HOSPITAL 
428 WEST, 59TH STREET 
NEW YORK 19, NEW YORK. 



JANUARY. 1959 • Vol. 55, No. 1 



69 




POSEY PATIENT SUPPORT 

Patenf Pending 

The Posey Patient Support was designed to 
fill a long-felt need. It is used on wheel- 
chairs or conventional chairs. It is possible 
to get a bed-patient up into a chair with 
safety and with no fear of danger. Gene- 
rously designed to accommodate practically 
all size patients and all types of chairs. 
Available in small, medium and large sizes 
in two models. Standard Model, Cat. No. 
PP-753, $5.85 each. Adjustable shoulder 
strap model, Cat. No. PP-154, $7.50 each. 



J. T. POSEY COMPANY • 2727 E. FOOTHILL BLVD., PASADENA, CALIF. 



ONTARIO 

District 1 
Windsor 
Grace Hospital 

Senior Major Mabel Crolly, a graduate of 
1945, was appointed superintendent recently. 
She replaces Senior Major Gladys Barker 
who has retired. Over 200 nurses gathered 
for a party in honor of Major Barker, 
some of them travelling considerable dis- 
tances to be on hand. Besides this she was 
the guest of honor at a tea held by the 
Ladies' Auxiliary, a luncheon arranged by 
the medical Advisory Group, a staflf recep- 
tion and an officers' dinner meeting. 

Major Crolly, the new superintendent, 
received her certificate in teaching from the 
University of Toronto School of Nursing. 
She was director of nursing services succes- 
sively at Grace Hospital, St. John's, Grace 
Hospital. Winnipeg and Grace Hospital. 
Windsor. Following this, she went to Grace 
Hospital, Calgary as superintendent where 
she remained for over three years before 
being sent to Ottawa's Grace Hospital in the 
same capacity. She left that city to accept 
her present appointment. 

Hotel Dicii Hospital 

The annual bazaar arranged by the alum- 
nae association was held in the Jeanne 
Mance residence in November. The proceeds 
are directed mainly to the bursary presented 
each year. The aimual meeting was also held 
during the same month. In December a 
Christmas party took the place of the regular 
alumnae meeting. Members exchanged gifts, 
enjoyed the program of entertainment, and 
spent a social hour following it. H. Masse 
is working at the Ottawa Civic Hospital. 

District 4 
St. Catharines 
General Hospital 

The Mack Training School alumnae asso- 
ciation has Elizabeth Goold for its president 
this year. Activities for the fall got under- 



way with a tea and bake sale, the proceeds 
to be used in celebrating the 85th anniversary 
of the school in June, 1959. Miss Goold 
spent a year in Europe recently and has 
shared her experiences generously with the 
alumnae members through her colored slides. 
In December Mr. M. A. Seymour, local 
lawyer and secretary of the Board of 
Governors discussed legal aspects of nursing 
when he attended a regular meeting as 
guest speaker. 

District 5 
Toronto 

East General Hospital 

On October 25, 1958 the class of '57 held 
their first reunion supper and dance. Every- 
one had a wonderful time renewing friend- 
ships with classmates who, in many cases, 
had not been seen since student days. R. 
(Mclnnis) Robinson, L. (Cunningham) 
Mason and J. (Saunders) Jones were 
there, much to the pleasure of the group. 
The success of this first anniversary was due 
to the good work of J. (Jackson) Stephany 
and her assistants, P. Farley, C. McGhee, 
J. Dent and N. Lamkin. 

General Hospital 

A. Grenache ('57), M. Smith ('55), J. 
Gauley ('51), I. Dreschner, J. Finlayson 
have returned to various staff positions after 
completing postgraduate university study. 
Jessie F. Young ('37) has been appointed 
neurosurgical supervisor in the Central 
building. M. Dzwin ('54) has returned from 
New York to take up her new work in the 
Outpatient Department. V. Lindabury ('53) 
has been awarded the Business and Profes- 
sional Women's Club bursary which she 
will use to study for her B.Sc.N. at the 
University of Western Ontario. B. (Duval) 
\'arey and M. Hudak ('55) are taking the 
public health course at the University of 
Western Ontario. J. Cameron ('48) returned 
to the city after two years in Khartoum 
with WHO. M. Booth ('55) was recently 
appointed clinic nurse at the new Scarbo- 



70 



THE CANADIAN NURSE 



rough Centre of the Children's Aid Society 
of Metropolitan Toronto. 

District 8 
Ottawa 
Civic Hospital 

The annual alumnae bazaar was held early 
in November of last year in the nurses' resi- 
dence. H. L. Tovvlan who received the 
alumnae bursary-loan for 1958 is studying 
nursing education at the University of 
Western Ontario. R. Rogers is on leave 
of absence to attend Johns Hopkins Univer- 
sity, Baltimore. H. Cunningham has been 
appointed administrative assistant to the 
director of nursing. W. Lowe is attending 
the University of Toronto School of Nursing 
where he is majoring in nursing education. 
B. (Towns) Haggernian is the supervisor 
of the Supply Room at Toronto East Gene- 
ral Hospital. M. MacKay is on the operating 
room staff of Oshawa General Hospital. 
M. Tape and G. Hudson completed study in 
public health at the University of Western 
Ontario. S. (Holmes) McDougal is enrolled 
in the Public Health course at the University 
of Toronto and M. Wood is attending the 
University of Western Ontario. 

District 12 
KiRKLAND Lake 

The fall rally of the district organization 
of the R.N.A.O. was held at Red Pines 
Lodge, Lake Kenogami. A buffet supper 
preceded the business and program sessions. 
About 50 members and guests attended. 
Dr. Graham B. Lane, medical officer of 
health for the Porcupine Health Unit was 
the guest speaker. His subject, "Radiation," 
was of keen interest to all. He emphasized 
chest -X-raying in particular and indicated 
the methods used to reduce radiation hazards 
to a minimum. 

PRINCE EDWARD ISLAND 

Ch arlottetow n 

The Association of Nurses elected its 
officers for the current year recently. Those 
members forming the e.xecutive are : Pres., 
Mrs. V. MacDonald; Past Pres., Ruth I. 
Ross ; Vice Pres., Bernice Rowland, Alice 
Trainor;; Hon. Treas., Mrs. R. Palmer; 
Hon. Sec, Frances MacMillan; Exec. Sec- 
Registrar, Mrs. Helen L. Bolger; Committee 
Chairmen : Nursing Education, Sr. M. Mo- 
nica; Nursing Service, Ida MacKay; Public 
Relations, Hattie MacLaine ; Finance, Mrs. 
Lois MacDonald ; Legislation & Bylaws, 
Katherine MacLennan. 

SASKATCHEWAN 

Prince Albert 

Holy Family Hospital 

The following members of the alumnae 
association form the executive for the cur- 
rent year: Pres.. Mrs. Betty Leland ; \'ice- 
pres., Miss McLeod; Sec. -Treas., Olivette 
Belanger; Councillors, Mmes Bruce. Kasko, 
Weatherby, Melis ; Committees : Program 
Mrs. H. Redekapp : Membership, Mrs. L. 
Kent, Mrs. Stene, Mrs. McLean; Publicity, 
O. Belanger, Misses McLeod, Winnicki. 




EXCLUSIVE SOURCE 
FOR 

EVEREST GREEN 

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THERE ARE MANY 
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HANDBOOK OF 
CARDIOLOGY FOR NURSES 

By Walter Model!, Associate Pro- 
fessor, Cornell University Medical 
College, and Doris R. Schwartz, As- 
sistant Professor, Cornell University- 
New York Hospital School of Nursing. 
The only cardiology book written 
specially for nurses. Third edition, re- 
vised and enlarged. 334 pages, 1958. 
$5.50. 

ESSENTIALS OF 
THERAPEUTIC NUTRITION 

By Solomon Garb, Associate Professor 
of Pharmacology, Albany Medkral Col- 
lege. Discusses basic principles of 
nutrition. Outlines and explains thera- 
peutic diets in commonest use. 157 
pages, 1958. $2.50. 

THE RYERSON PRESS 
299 QUEEN STREET WEST, TORONTO 2-B 



JANUARY, 1959 • Vol. 55, No. 1 



71 



Employment Opportunities 

Advertising Rates — $5.00 for 2 lines or less; $1.00 for each additional line. 
U.S.A. & Foreign — $7.50 for 2 lines or less; $1.50 for each additional line. 

Closing date for copy and cancellations : 10th of the month preceding the month of 
publication. All letters should be addressed to : The Canadian Nurse, 1522 Sherbrooke St. W., 
Montreal 25, Quebec. 

Director of Nursing for new 33-bed General Hospital with well equipped surgery wing, in 
new mining town, about 250-mi. east of Port Arthur & northwest of White River, Ontario. 
Starting salary commensurate with experience & qualifications. Apply, stating qualifica- 
tions, experience, age, marital status, etc. to Mr. W. Harrison, Room 1715, 44 King Street 
West, Toronto, Phone EMpire 4-1194, or to the Administrator, Manitouwadge General 
Hospital, Manitouwadge, Ontario, Phone TAylor 6-3251. 

Director of Nursing for 180-bed hospital with a school of nursing. Applicant with University 
Degree &/or postgraduate course preferred. Salary commensurate with experience & 
qualifications, position available May 1959. Apply: Secretary, Board of Directors, Victoria 
Union Hospital, Prince Albert, Sask. 

Assistant Director of Nursing Education & Surgical Clinical Instructor for 85-student 
School of Nursing, 200-bed hospital, good personnel policies. Apply Director of Nursing 
Education, St. Michael's Hospital, Lethbridge, Alberta. 

Assistant Director of Nurses, Clinical Instructor and Staff Nurses. Rehabilitation nursing 
in crippled children's center. Top salaries. For further information, write Crotched 
Mountain Rehabilitation Center, Greenfield, New Hampshire. 

Supervising Nurse to help plan, equip & operate a new & modern intensive care unit of 
21-beds to be opened in the spring of 1959. Position available at once. Salary range 
between $345 - $410 depending on training & qualifications. Write, wire or call, collect, 
Director of Nursing, Samuel Merritt Hospital, Oakland, California, OLympic 5-4000. 

Assistant Night Supervisor — Head Nurses for Medical & Surgical Wards — General 
Duty Nurses for 450-bed hospital with training school. Excellent personnel policies. Apply 
to: Director of Nursing, St. Joseph's Hospital, Victoria, British Columbia. 

Matron — Salary, depending on qualifications; some x-ray experience desirable. Apply to: 
Mr. K. A. Sinclair, Secretary-Treasurer, Little Long Lac Hospital, Geraldton, Ontario. 

Assistant Matron with postgraduate preparation for 140-bed hospital with building 
program in operation. For further particulars, write Matron, King Edward VII Memorial 
Hospital, Bermuda. 

Superintendent of Nurses (Immediately) for 50-bed hospital. 3-room suite, 4-wk. vacation, 
all statutory holidays, salary open. Apply stating references, age, experience, to Secretary- 
Treasurer, Great War Memorial Hospital, Perth, Ontario. 

Assistant Head Nurses excellent personnel policies. Apply Director, Shriners' Hospital for 
Crippled Children, 1529 Cedar Avenue, Montreal, Quebec. 

Clinical Instructor (Medical Nursing) salary $3,480-$4,440 per annum. 40-hr. week. Apply to. 
Director of Nursing, City Hospital, Saskatoon, Saskatchewan. 

Registered Nurse (1) Licensed Practical Nurse (1) immediately, for 10-bed hospital, 
salary R.N. $300 per mo., L.P.N. $200, less $25 per mo. full maintenance, living quarters 
in hospital. Apply: Birch River Hospital Unit, Birch River, Manitoba. 

Registered Nurses (2) for 16-bed hospital 130-mi. west of Winnipeg. Salary $265 gross 
with increments of $5 every 6-mo. for 4 increases; 8-hr. day; 44-hr. week. 10 statutory 
holidays; 3-wk. vacation first yr. then 4-wk. Living quarters in hospital; room (S board 
$35 per mo. Apply: Secretary or Matron, Memorial Hospital, Crystal City, Manitoba. 

Registered Nurses for modern hospital, comfortable home. Starting salary $250 per mo., 
maintenance $35 per mo. Apply: Superintendent, Lome Memorial Medical Nursing Unit, 
Swan Lake, Manitoba. 

Registered Nurses for 206-bed hospital. Basic gross salary $220 plus $5 increase after 
6-mo., for 4 years. Included are statutory holidays <S sick leave. Positions available 
in all areas. Apply to Director of Nursing, Hotel-Dieu St. Joseph, Edmunston, N.B. 

72 THE CANADIAN NURSE 



Registered Nurses for 46-bed hospital in the AnnapoHs Valley, salary according to R.N. A. 
suggested policy. Apply: to the Superintendent, Western Kings Memorial Hospital, 
Berwick, Nova Scotia. 



Registered Nurses; for 50-bed Hospital, Obstetrical & General Duty. Rotating shifts, 40-hr. 
wk. Apply: Director of Nursing, Ajax & Pickering General Hospital, Ajax, Ontario. 

Registered Nurses for General Duty modern 18-bed Private Hospital in Iron Mining 
town, 180-mi. north of Sault Ste. Marie, Ont. Excellent accommodations & personnel 
policies. Starting salary $255 minimum to $290 maximum for experience, less $20 per mo. 
maintenance. Transportation allowance after 3-mo. service. Apply Superintendent, Miss 
O. Keswick, Lady Dunn Hospital, Jamestown, Ontario. 

Registered Nurses for general duty in all departments — including operating room, pre- 
mature & newborn nursery. Good salary & personnel policies. Apply: Director of I^'ursing, 
Victoria Hospital, London, Ontario. 

Registered Nurses for Nipigon District Memorial Hospital, Nipigon, Ontario. Starting 
salary $265 per mo. & additional increm.ent for 3-yr. experience or more. Board & room 
available at $28.50 per mo., 5V2-day wk. 8-hr. duty. 4-wk. vacation after 1-yr. Sick leave, 
1 day mo. Apply to: Mrs. G. Gordon, Superintendent, Box 37, Nipigon, Ontario. 

Registered Nurses or equivalent European training (3) for 30-bed rural General Hospital. 
Starting salary $160 per mo. full room & board free. Blue Cross paid, 46-hr. wk. 8-hr. general 
duty, 1-wk. vacation each quarter (V4), 20-mi. from Ottawa. Skiing, skating, swimming, 
boating etc. Apply to: Miss Hardy, Matron, Gatineau Memorial Hospital, Wakefield, Que. 

Registered Nurses (2) $260 per mo. with increments each yr. 3-wk. vacation & sick leave, 
residence on grounds. Apply to Secretary, Vanguard Union Hospital, Vanguard, Sask. 

Registered Nurses: Positions available in all areas & on all shifts. Ultra modern, new 
254-bed General Hospital located in the heart of beautiful sunny Castro Valley, just 30 
minutes drive from San Francisco. This is a busy residential community which offers 
casual California living at its very best. Many excellent schools & colleges within easy 
commuting distance. Progressive personnel policies include free hospital & surgical in- 
surance, paid sick leave, paid vacations, 7 recognized holidays & other benefits. No split 
shifts; evening & night duty salary differential, also differential paid for operating room, 
delivery room & nursery service. Uniforms laundered free. Basic salary for general staff 
duty, $320 per mo. Salaries for other positions commensurate with assignments. Please 
write: Personnel Manager, Eden Hospital, 20103 Lake Chabot Road, Castro Valley, Calif. 

Registered Nurses for new 157-bed General Hospital located in fast growing City of 
Fremont approximately 1-hr. from heart of San Francisco. Good salary, vacation, sick 
leave & hospitalization plan. Contact Director of Nursing Services, Washington Township 
Hospital, P.O. Box 656, Niles, California. 

Registered Nurses: Spend your winter in the Sunny Southwest — New Mexico, "The 
land of Enchantment". Vacancies for staff duty in Medicine, Surgery, Obstetrics, 
Pediatrics, and Operating Room. Salaries $285-$315, days; $10 differential for evenings 
& nights; $15 differential, operating room. No shift rotation. Excellent job benefits. Board 
and room in nurses' residence, $43 per month. Free transportation via 1st Class Air 
travel to Albuquerque and return in exchange for a 1-yr. employment contract. Write 
or call collect Mrs. Margaret Nelson, Director of Nursing, Presbyterian Hospital Center, 
1012 Gold Ave. S.E. Albuquerque, New Mexico. Phone 3-5611. 

Registered Nurses for new 50-bed hospital. Openings on obstetrical wing, evening and 
night shift. Salary $310. Transportation paid to New Mexico in exchange for 1-year 
employment contract. Write to Director of Nurses, Carlsbad Memorial Hospital, 
Carlsbad, New Mexico. 

Registered Nurses & Certified Nursing Assistants (immediately) for 73-bed General Hos- 
pital on Lake of the Woods. Favorable salaries & personnel policies. Living conditions 
available. Apply Superintendent, Kenora General Hospital, Kenora, Ontario. 

Registered Nurses & Certified Nursing Assistants for new expanding 88-bed hospital in a 
pleasant progressive town. General Duty Registered Nurses start $220, annual increments 
to $240, Certified Nursing Assistants $150, annual increments to $180. 2-wk. shift rotation, 
bonus for 4-12 & 12-8 shifts. Accumulated sick leave to 60-dy. Only 1-hr. drive to Toronto, 
to other cities & resort areas. Local swimming pool, artificial ice arena, bowling, etc. 
Apply: Director of Nursing, Dufferin Area Hospital, Orangeville, Ontario. 

JANUARY, 1959 • Vol. 55, No. 1 73 



Registered Nurse & Licensed Practical Nurse for general floor duty. Gross salary $290 per 
month for R.N., $200 per month for L.P.N, with $25 deducted for full maintenance. 44-hr. 
week. For further particulars please apply to John Hiscock, Secretary-Treasurer, Medical 
Nursing Unit, Baldur, Manitoba. 

Registered Nurses & Licensed Practical Nurses for new 33-bed General Hospital with well 
equipped surgery wing, in new mining town, about 250-mi. east of Port Arthur & northwest 
of White River, Ontario. Starting salary commensurate with experience & qualifications. 
Apply: stating qualifications, experience, age, marital status, etc. to Mr. W. Harrison, 
Room 1715, 44 King Street West, Toronto, Phone EMpire 4-1194, or to Administrator, Mani- 
touwadge General Hospital, Manitouwadge, Ontario, Phone TAylor 6-3251. 

Registered Nurses for Operating Room & General Duty Nursing, for 20-bed private hospital. 
Rotating shifts, averaging 42-hr. per wk. Salary $259 per mo., plus full maintenance. 
Accommodations provided in nurses' residence — single rooms. Liberal personnel poli- 
cies, group insurance, pension plan, 1-mo. vacation after 1-yr. service. Sick leave. Excellent 
recreational facilities. Located in Thunder Bay District of Ontario, on Main C.P.R. Trans- 
continental line & Trans Canada Highway. Apply: Employment Supervisor, Marathon 
Corporation of Canada Limited, Marathon, Ontario. 

Registered Nurses for Operating Room with operating room postgraduate courses and/or 
experience, for 140-bed hospital. Travel allowance paid. For particulars, write Matron, 
King Edward Vll Memorial Hospital, Bermuda. 



Registered Nurses for General Staff & Operating Room in modern hospital (opened in 
1956). Situated in the Nickel Capital of the world, pop. 50,000. Salary: $260 per mo. with 
semi-annual merit increments, plus annual bonus plan. Recognition for experience. Excel- 
lent personnel policies. Assistance with transportation can be arranged. Apply Director of 
Nursing, Memorial Hospital, Sudbury. Ontario. 

Registered Laboratory Technician (Male or Female) will consider recent graduate who has 
not taken the Registry. Good personnel policies; salary open. Write or phone: Administra- 
tor, Sidney A. Sumby Hospital, River Rouge 18, Michigan. 

Surgical Registered Nurses, Staff Registered Nurses for 240-bed General Hospital. 40- 
hr. wk. 15 working days; paid vacation; 7 paid holidays; sick leave. Surgery starting 
base pay $338 stand by & call back time extra. Staff R.N. starting pay $322 monthly; 
regular pay increases; P.M. & night differential $10. Apply: Yolo General Hospital, 
P.O. Box 210, Woodland, California. 

Registered General Duty Nurses (2) Starting salary $260 gross, personnel policy upon 
request, living in residence. Apply, Matron, Myrnam Municipal Hospital, Myrnam, Alta. 

Registered General Duty Nurses. Salary: $230 per mo. 40-hr. wk. Apply Director of Nursing, 
General Hospital, Cobourg, Ontario. 

Registered Nurses for General Duty good salary with full maintenance & laundry. Excel- 
lent accommodation in nurses' residence, single rooms. Good working conditions. For 
application please write to Superintendent of Nurses, Mount Sinai Sanatorium, Ste. 
Agathe des Monts, Quebec. 

Registered General Duty Nurses for 118-bed General Hospital along the shores of Lake 
Michigan, 25 mi. from Chicago. Salary: $340 for days, $370 for evenings, $360 for nights. 
5 day wk. Good personnel policies. Apply Personnel Director, Highland Park Hospital 
Foundation, 718 Glenview Ave., Highland Park, 111. 

General Duty Registered Nurses for 100-bed general hospital in town of 6000 on the shore 
of Lake Huron. Good personnel policies, residence accommodation available. Apply: 
Superintendent, Alexandra Marine & General Hospital, Goderich, Ontario. 

General Duty Registered Nurses & Operating Room Nurse (1) for new 56-bed hospital 
on Georgian Bay. Attractive residence. Gross salary $225 per mo. for general duty, 
44-hr. wk. All statutory holidays, 12-dy. sick leave. 3-wk. vacation after 1-yr. Apply to 
Director of Nursing, Meaford General Hospital, Meaford, Ontario. 

Baker Memorial Sanatorium, Calgary, Alberta, offers to Graduate Nurses a 6-mo. post- 
graduate course in Tuberculosis. Salary: $3,480 to $4,080 per annum. Openings also avail- 
able for General Duty Nurses. Residence with board, if desired, $30 per mo. Excellent 
holiday, sick leave & pension benefits. Apply to: Superintendent of Nurses. 

General Duty Nurses (3) for 64-bed hospital, salary $250 less $35 for room & board, $5 
increase after 6-mo. for 6 increases, 44-hr. wk. 4-wk. paid vacation after 1-yr. service. 
Statutory holidays, lV2-dy. sick leave per mo. Transportation up to $50 refunded after 1-yr. 
service. Apply: Sister Superior, Providence Hospital, High Prairie, Alberta. 

74 THE CANADIAN NURSE 



General Duty Nurses for R. W. Large Memorial Hospital United Church oi Canada at Bella 
Bella 300-mi., north of Vancouver on B.C. Coast. Transportation refunded after l-yr., Apply 
to, Matron, R. W. Large Memorial Hospital, Bella Bella, British Columbia. 

General Duty Nurses for a new 26-bed hospital in the Fraser Valley, 100-mi. from Van- 
couver. Good personnel policies, accommodation available in a new residence. Apply 
Director of Nurses, Fraser Canyon Hospital, Hope, British Columbia. 

General Duty Nurses for new 85-bed hospital. Good salary & generous personnel policies. 
Apply to the Director of Nursing, Portage Hospital Dist. #18, Portage la Prairie, Manitoba. 

General Duty Nurses for modern 35-bed hospital situated on beautiful South Shore. Good 
personnel policies. Excellent living quarters. Apply Superintendent, Fishermen's Memorial 
Hospital, Lunenburg, Nova Scotia. 

General Duty Nurses for an accredited 64-bed hospital. Starting salary: $235 per mo. 
with annual increments. Good personnel policies with sick leave benefits, holidays & 
paid vacation. Residence accommodation available. Apply Director of Nursing, Douglas 
Memorial Hospital, Fort Erie, Ontario. 



McKellar General Hospital, Fort William, Ontario requires General Duty Staff Nurses 

interested in coming to northwestern Ontario. Basic salary, $250 per mo. 40-hr. wk. Good 
personnel policies. Renovation program now complete. Openings in all departments. For 
further information apply to the Director of Nursing. 

General Duty Nurses for modern 42-bed hospital, starting salary, new graduates $255 with 
two (2) yr. experience $270 provided Ontario registration is obtained; these rates to be 
revised October 1st. Ontario registration required for maximum salcfry. Annual increments, 
6% bonus for evening & night shifts. 44-hr. wk. with 8 statutory holidays, annual vacation 
21 days first yr. 28-dy. thereafter, monthly sick time allowance. Good living accommoda- 
tions available. Apply to: Nursing Supervisor, Sioux Lookout General Hospital, Sioux 
Lookout, Ontario. 

General Duty Nurses for 163-bed Tuberculosis Sanatorium. Good salary & personnel 
policies. Residence accommodation available. Please apply Director of Nurses, Sudbury & 
Algoma Sanatorium, P.O. Box 40, Sudbury, Ontario. 

General Duty Nurses (3) for new 11-bed hospital, $260 per mo., benefits according to 
S.R.N. A. Apply with references to Matron, St. Walburg Union Hospital, St. Walburg, Sask. 

General Duty Nurses (English speaking) for 466-bed hospital. Nurses' residence available. 
Salary: $315, California registered — $285, Canadian registered. $22.50 differential for 3-11 
& 11-7 shifts. Apply Cedars of Lebanon Hospital, 4833 Fountain Ave., Los Angeles, Calif. 



General Duty Nurses for 600-bed teaching hospital in central California. Inservice educa- 
tional program; 40-hr. wk., 11-holidays yearly, retirement <S sick leave plan. P.M. <S night 
shiit differential. $337 per-mo. to start. Write Personnel Director, 732 East Main St., Stockton, 
California. 

General Duty Nurses & Operating Room Nurses for 434-bed hospital; 40-hr. wk. Statutory 
holidays. Salary $250-$312. Credit for past experience & postgraduate training. Annual 
increments; cumulative sick leave; 28 days annual vacation; B.C. registration required. 
Apply Director of Nursing, Royal Columbian Hospital, New Westminster, B.C. 

Attention! General Duty & Surgery Nurses for 400-bed County Hospital located 2-hr. drive 
from San Francisco, ocean beaches, & mountain resorts in modern & progressive city of 
35,000. 40-hr. 5-day wk., 3-wk. paid vacation, 11 paid holidays, paid sick leave, retirement 
plan 6t social security. Accommodations in Nurses' Home, meals at reasonable rates, 
uniforms laundered without charge. General Duty, $333 mo. start plus shift & service 
differentials. Surgery $382-$460 mo. comp. time if on call. Must be eligible for Calif. Regis- 
tration. Write Director of Nursing, Stanislaus County Hospital, 830 Scenic Drive, Modesto, 
California. 

General Duty Nurses & Certified Nursing Assistants for 86-bed hospital. Living ac- 
commodation available. Collingwood is situated on Georgian Bay & is noted as a 
vacation land in summer with 7-mi. of sand beach, along with great skiing on the 
Blue Mountains in winter. For further information apply Director of Nursing Services, 
General & Marine Hospital, Collingwood, Ontario. 

Registered Nurses for general duty, obstetrics & operating room, starting salary $320 per 
mo., $10 differential paid for afternoon & night shifts, also for obstetrics, nursery 6. 
operating room; 40-hr. wk.; liberal vacation policy; sick leave; holidays; paid health 
insurance. Moving into new hospital building January, 1959. Apply: Personnel Director, 
Fresno Community Hospital, Fresno, California. 

JANUARY. 1959 • Vol. 55, No. 1 75 



General Duty Nurses & Certified Nursing Assistants; living-in accommodation, comparable 
salaries, 44-hr. week. Apply Memorial Hospital, Durham, Ontario. 

General Duty Graduate Nurses for an active 76-bed hospital near Calgary & Banff. $250 
gross salary, $260 for Alberta registered, good personnel policy. Apply to Matron, Brooks 
Municipal Hospital, Brooks, Alberta. 

Graduate Nurses for 70-bed General Hospital. Salary $260-$280; 5-day wk., 28 days vaca- 
tion plus 10 statutory holidays, after 1 yr. Apply: Matron, St. George's Hospital, Alert Bay. 
British Columbia. 

Graduate Nurses for new 140-bed hospital. 1. Charge nurse for Central Supply, to open 
and organize dept. 2. Head nurse for Pediatric dept. 3. Head nurse for men's Medical 
and Surgical 24-bed dept. 4. Operating Room nurse (1)5. General duty nurses. Positions 
1 to 4 all to have postgraduate courses or equivalent in experience. Salaries and 
personnel policies in accordance with R.N. A. B.C. Positions open August to November 1. 
Apply, Director of Nursing, General Hospital, Chilliwack, B.C. 

Graduate Nurses; for new 63-bed hospital, 30 miles from Vancouver in the Fraser Valley. 
For Salary rates & Personnel policies. Apply: Director of Nursing, Maple Ridge Hospital, 
Apply, Director of Nursing, General Hospital, Chilliwack, British Columbia. 

Graduate Nurses for 37-bed hospital, salary $250 per mo. with annual increments — 28-dy. 
annual vacation, cumulative sick leave — $50 monthly; board, lodging, laundry. New 
50-bed hospital to be erected 1959. Apply: Administrator, Terrace & District Hospital, Box 
1297, Terrace, British Columbia. 



General Staff Nurses for 400-bed Medical & Surgical Sanatorium, fully approved student 
affiliation & postgraduate program. Full maintenance. Recreational facilities. Vacation 
with pay. Sick benefits after 1 yr. Blue Cross coverage. Attractive salary; 40-hr. wk. For 
further particulars apply Supt. of Nurses, Nova Scotia Sanatorium, Kentville, N.S. 

General Staff Nurses for 370-bed approved General Hospital with intern & resident pro- 
gram. $315 per mo. starting salary. $15 per mo. merit increases at 12, 24 & 36 mo. 40-hr. wk. 
2-wk. paid vacation, paid sick leave, 7 paid holidays. Pleasant coast city in outstanding 
recreational area. Apply Director of Personnel, Seaside Memorial Hospital, Long Beach 13, 
California. 

Staff Nurses for 250-bed General Hospital, located on the Bay of Quinte; approved School 
of Nursing; planned In-Service education program; desirable personnel policies. For 
further information. Apply to: Director of Nursing, General Hospital, Belleville, Ontario. 

Staff Nurses 600-bed general & tuberculosis teaching institution in central valley City. 
Accredited State & Junior Colleges in immediate vicinity, Liberal personnel policies. 
Salary $320-$360. Full maintenance available. Write — Director of Nursing Service, 
Fresno County General Hospital, Fresno 2, California. 



,-^: 



taff Nurses for 300-bed General Hospital. Attractive personnel policies plus differential 
for specialties, afternoon & night duty. Opportunities for advanced education. Apply to 
Director of Nursing Service, Kai-^er Foundation Hospital, Oakland 11, California. 

Staff Nurses: Relocate to Sacramento, Calif. Sutter Community Hospitals, 440-beds, offer 
$340 per mo. starting salary, $25 per mo. for p.m. & night differential. Tenure salary 
increase plan, 40-hr. wk.. Social Security & liberal employee benefit program. Write to 
Personnel Office. 

Pediatric Nurses for 100-bed Pediatric teaching hospital; air conditioned. Good personnel 
policies. Base salary-rotation $290 per mo. Evenings or night $304 per mo. Apply: Director 
of Nursing Service, University of Texas Medical Branch, Galveston, Texas. 

Operating Room & General Duty Nurses for expanding active 350-bed General Hospital. 
8-hr. day, 5-dy. wk. with 3-wk. vacation for 1st & 2nd year; thereafter, 4-wk. Apply: Director 
of Nursing, Port Arthur General Hospital, Port Arthur, Ontario. 

Operating Room Nurse (P.M.) for 147-bed General Hospital located in a beautiful resi- 
dential surburb along the North Shore of Chicago. Modern ranch style nurses' homes 
with attractively furnished private bedrooms. 40 hr. wk. Salary: $365 for days, $395 for 
evenings. Other employee benefits. Contact the Personnel Director, Highland Park Hospi- 
tal Foundation, Highland Park, Illinois. 

76 THE CANADIAN NURSE 



Public Health Nurses: required in a generalized program in rural & semi-urban area 

adjacent to metropolitan Toronto. Excellent working conditions including pension plan, 
group insurance & transportation arrangements. Write: Dr. R. M. King, York County Health 
Unit, Newmarket, Ontario. 

Public Health Nurses for generalized program, rural & urban. Salary range $3,300-$4,300, 
annual increment $200, pension plan, Blue Cross, 4-wk. vacation, cumulative sick leave. 
Apply: J. R. Mayers, M.D., D.P.H., Director, Norfolk County Health Unit, 58 Peel Street, 

Simcoe, Ontario. 

rijrses for floor duty in 54-bed General Hospital. 5-dy. wk. with sick leave & vacation. 
State Nurses Association pay scale. Write or phone McMinnville Hospital, Inc., 
McMinnville, Oregon. 

Public Health Nurse (Qualified) minimum salary $3,200; allowance for experience. $150 

annual increments; 5-day week; 4wk. vacation; sick leave credits; Blue Cross, pension 
plan, car allowance. Financial assistance towards purchase of car. Apply to Mr. A. F. 
Stewart, Secretary-Treas., Wentworth County Health Unit, Court House, Hamilton, Ontario. 

Operating Room Supervisor, Operating Room General Duty Nurse for 110-bed modern 
hospital. Excellent personnel policies. Apply: Superintendent, Charlotte County Hospital, 
St. Stephen, New Brunswick. 

Operating Room Nurse for 205-bed new hospital in Georgian Bay Area. Live in if desired. 
Apply: stating experience, to Director of Nursing, General & Marine Hospital, Owen 
Sound, Ontario. 

Operating Room Supervisor (Immediately) for 86-bed hospital. Good salary, employee 

benefits & statutory holidays, living accommodation available in residence. Locate in Col- 
lingwood & enjoy many winter sports along with excellent skiing in the Blue Mountains. 
Apply, Director of Nursing Services, General & Marine Hospital, Collingwood, Ontario. 

Graduate Nurses for Eastern Townships Hospital. 28 days annual holiday. Complete 
maintenance. Salary commensurate with experience. Apply, E. Decker, Brome-Missis- 
quoi-Perkins Hospital, Sweetsburg, Quebec. 

General Staff Nurses for fully accredited private teaching hospital, located on Lake 

\ Michigan just north of Chicago. 5-day, 40-hr. wk. Salary range $337.35 to $363.30. Shift 

-^bonus: $26 afternoons & $17 nights. Progressive personnel policies. Please indicate type of 

service preferred. Apply: Director of Nursing, Evanston Hospital, 2650 Ridge Avenue, 

Evanston, Illinois. 



Registered Nurses; staff positions; starting salary $355 per month. Competent nurses 
who have had six months experience in accredited hospitals may qualify as Assistant 
Head Nurses, $395. Differential for evening and night duty, full Civil Service benefits, 
40-hour week, paid overtime. Choice of services. Current openings are on Medicine, 
Orthopedics, Communicable Diseases, G.U., or Neurology. R.N.s must speak and write 
English. For full details, write: Mrs. Betty Hartwig, R.N., Los Angeles County General 
Hospital, 1200 North State Street, Los Angeles 33, California. 

Staff Nurses (3 immediately) for 18-bed Community Hospital in scenic setting in the heart 
of the Canadian Rockies. Starting salary $250 per mo. FuUl maintenance available in 
modern nurses' residence. For full particulars write: C. F. Collins, Secretary, General Hos- 
pital, Golden, British Columbia. 

Nursing Supervisor for community owned 18-bed General Hospital. Full maintenance $48 
per mo., in new modern nurses' residence on hospital grounds. Scenic location, in Rocky 
Mountains west of Calgary, Alberta on Trans Canada Highway. For full particulars write: 
C. F. Collins, Secretary, General Hospital, Golden, British Columbia. 

Matron (Immediately) for 5-bed medical nursing unit. Salary $275 less maintenance, 44-hr. 
wk., excellent staff accommodation. 80-mi. west of Winnipeg on No. 1 highway, good train 
& bus service. For further particulars, apply to Mrs. M. C. Roberts, Sec'y. of North Norfolk- 
MacGregor Medical Nursing Unit, MacGregor, Manitoba. 

General Duty Graduate Nurses (2). Salary $260 per mo. with annual increments of $10 per 
mo. Room, board & laundry: $40. 28-day vacation after 1-yr. service. All statutory holidays 
paid. Customary sick leave. Graduate complement, 5. Apply giving full details to Matron, 
Slocan Community Hospital, New Denver, B.C. 

■JANUARY. 1959 • Vol. 55, No. 1 77 



PUBLIC HEALTH NURSES GRADE (1) 

British Columbia Civil Service 

Positions available for qualified Public Health Nurses in various centres in B.C. 

Salary: $290 rising to $345 per mo., car provided. An opportunity for 
interesting & challenging professional service in this beautiful & fast developing 
province. Competition No.: 58:511. 

For information & application forms, write 

THE DIRECTOR, 
PUBLIC HEALTH NURSING, DEPT. OF HEALTH, VICTORIA, B.C. or 

THE CHAIRMAN, 
B.C. CIVIL SERVICE COMMISSION, 544 MICHIGAN STREET, VICTORIA, B.C. 



Dietitian for 90-bed accredited Hospital. Help maintain patients contact; salary open, 
excellent benefits. Write or phone: Administrator, Sidney A. Sumby Hospital, River Rouge 
18, Michigan. 

Chief Dietitian for 140-bed hospital. Training school affiliated with Montreal hospitals. 
Fare paid. For particulars write Matron, King Edward VII Memorial Hospital, Bermuda. 

General Duty Nurses for small active hospital. Salary $250 for unregistered. $260 
registered with yearly increments. Nurses' Home available. For further particulars write. 
The Administrator, Lady Minto Hospital, Ashcroft, British Columbia. 

Director of Nursing for approved I.C.A.H. 108-bed hospital planning a 100-bed addition. No 
school of nursing at present. Degree in nursing administration preferred but not essential. 
Successful experience in nursing education would be an advantage. Salary open. Person- 
nel policies include 40-hr. wk. pension plan, sick leave, 4-'wk. vacation after 1-year of 
service, 8-statutory holidays. Apply: Administrator, Civic Hospital, North Bay, c3ntcrrio. 



KINGSTON 
GENERAL HOSPITAL 

KINGSTON, ONTARIO 

requires 
Director of Nursing Education (1) by 
July, 1959. Qualifications — Bachelor 
of Science in Nursing Degree plus 3-5 
years experience. 

IMMEDIATELY 

1 . Qualified Clinical Instructresses. 
Maternity (1 ) Medicine (1 ) and 
Surgery (1). 

2. General Duty Nurses (1 2) 

3. Practical Nurses (6) 

Salary commensurate with preparation & 
experience. 

Apply: Director of Nursing 



THE ONTARIO SOCIETY 
FOR CRIPPLED CHILDREN 

92 College St., Toronto 2 

requires 

Experienced Public Health Nurses 

Good salary range & personnel policies 

Apply: 

SUPERVLSOR OF NuRSING SERVICES 



ASSISTANT DIRECTOR 
OF NURSING 

required 

for 105-bed hospital 

Salary $275 - $325 

Good personnel policies. 

Apply to Administrator, 
THE COTTAGE HOSPITAL, PEMBROKE, ONTARIO 



78 



THE CANADIAN NURSE 




NURSES WHO LIVE 

HERE NEVER STOP 

LEARNING . . . 

GROWING 

. . . THEY WORK AT 

COOK COUNTY 
HOSPITAL 

... in one of the Largest 

Most Stimulating Medical 

Centers in the World 



Residence, Cook County School of Nursing 

Here's an opportunity to gain unique and valuable experience in a public hospital — world's 
largest for acute medical conditions. Cook County Hospital offers you the stimulation of working 
with more than 2,500 other doctors and nurses in one of the world's largest and most exciting 
medical centers. Housing is available at nominal cost. Salaries begin at $340-$350 for a SV/j 
hour week. And you're only minutes from Chicago's fabulous Loop and local universities. 
Graduate Nurses! Write today to Director, Cook County School of Nursing, Dept. C, 1900 West 
Polk Street, Chicago 12, Illinois. 



DIRECTOR - SCHOOL OF NURSING 

For a school of 90-students, organized independently of Nursing Services. 

The school program follows the pattern of 2-years of nursing education plus 
1-year of internship. 

Requirements: Degree & experience in the administration of a nursing educa- 
tion program. 

Apply to: R. Buckner, Administrator, 

Metropolitan General Hospital, 
Windsor, Ontario. 



NURSES REQUIRED 

at 

Roseway Hosp., Shelburne, M.S. 

Superintendent of Nurses — required 
March 1st and immediately 
Assistant Superintendent of Nurses 
General Hospital: General Duty Nurses 
Maternity Nurses 
Nursing Assistants 
Tuberculosis Hospital: General Duty Nurses 
Nursing Assistants 

Additional information may be obtained from 

Miss K. B. Harvey, R.N. , Superintendent of Nurses 

Apply tO: 

NOVA SCOTIA CIVIL SERVICE COMMISSION 

P.O. BOX 943, HALIFAX, NOVA SCOTIA 

2064 



THE 


CENTRAL REGISTRY 


OF 


GRADUATE NURSES 




TORONTO 




Furnish Nurses 




• at any hour • 




DAY or NIGHT 


TELEPHONE WAInut 2-2136 


427 


Avenue Road, TORONTO 7 




Jean C. Brown, Reg. N. 



JANUARY, 1S>59 • Vol. 55, No. 1 



79 



SARNIA, ONTARIO 

CERTIFIED NURSING 
ASSISTANTS 

As an employee of our modern well 
equipped hospital, you may enjoy 
the excellent opportunities offered 
as resident of this progressive in- 
dustrial city. 

Positions are available in all 
services. 

SALARY RANGE IS FROM 
$2,100 TO $2,508. 

Excellent employee benefits in- 
clude 40-hour, 5-day v/eek. Shift 
differential for evening and night 
shiffs. 9 statutory holidays. 

Please apply to: 

PERSONNEL DIRECTOR 

SARNIA GENERAL HOSPITAL, 

SARNIA, ONTARIO 



THE NATIONAL HOSPITAL 

QUEEN SQUARE 

London, W.C.I 

and 

MAIDA VALE HOSPITAL 

London W.9, England 

(Institute of Neurology, University of 
London) 

Postgraduate Nursing Education for 

Medical Neurology & Brain Surgery 

One year courses are open to Nurses on 

the General Register with good educational 

background. 

3 mo. full time instruction in the school 
under guidance of the Sister Tutor assisted 
by a teaching staff of senior neurologists 
& neuro-surgeons. 

8-mo. clinical experience, 1 mo. vocation. 

Certificate & badge of the hospital awarded 
to successful students. Staff nurses' salary 
paid throughout the year. This work has a 
special appeal to nurses interested in 
research & the humanitarian aspect of 
nursing. 

For further parficulars apply to the Matron, 

THE NATIONAL HOSPITAL 



PSYCHIATRIC NURSING INSTRUCTRESSES 

required by the 
SASK. DEPT. OF PUBLIC HEALTH 



SALARY: 



REQUIREMENTS: 



DUTIES: 



APPLICATIONS: 



$375 per month for those with postgraduate training; $359 
for those without this training. 

R.P.N, and/or Reg. N., preferably both registrations and 
postgraduate training in nursing teaching and supervision. 
Consideration will be given to those who have registration 
in either field of nursing but who do not have the required 
postgraduate training but are interested in provisional 
appointments pending formal training for which financial 
assistance may be provided. 

Appointees will serve as instructresses in a three year, 600 
hour training program for student psychiatric nurses. They 
will give lectures, lead seminars and give practical demon- 
strations designed to co-ordinate classroom theory and 
work on the wards. 

Forms and further information available at Public Service 
Commission, Legislative BIdg., Regina. Applicants should 
refer to file number 5706. 



80 



THE CANADIAN NURSE 




GO NO 
FURTHER! 

YouHl find 
the experience 
at HOPKINS 



JOHNS HOPKINS offers 

• An exciting nursing career in a big and busy 
medical center. 

• Staff nurse positions in all clinical fields, with 
notable opportunities jar advancement. 

• Liberal personnel policies, including Group Life 
Insurance and Retirement Income Plans. 




WRITE: 

DIRECTOR OF NURSING SERVICE 
THE JOHNS HOPKINS HOSPITAL 
BALTIMORE 5, MARYLAND 



JANUARY. 1959 • Vol. 55. No. 1 



81 



NURSING INSTRUCTOR 

School with 45 students — 1 class a year. 5-day 8-hr. week. Personnel Policies 
excellent. Not necessary to teach science subjects. 

Sherbrooke, a very attractive & interesting City in the Eastern Townships, 
easily accessible to Montreal. 

Apply to 
DIRECTOR OF NURSING, SHERBROOKE HOSPITAL, SHERBROOKE, QUE. 



OPERATING ROOM NURSE 

(EXPERIENCED) 
For new 85-bed General Hospital. Situated in a city of 
10,000 population with (2) R.C.A.F. Bases and has 
many recreational facilities. 

APPLY: THE ADMINISTRATOR, 
THE PORTAGE HOSPITAL, DISTRICT 18, PORTAGE LA PRAIRIE, MANITOBA 



THE PROVINCE 
OF MANITOBA 

requires 

A Number of 

Public Health Nurses 

to work in rural 

Health Units 

Applicants should be nurses registered 
in Manitoba preferably with post- 
graduate training in Public Health 
Nursing or willingness after one year's 
employment to take postgraduate 
training in Public Health. 
Salary schedule with R. N. only 
$3,1 20-$4,020 per annum. 
With R. N. plus certificate in Public 
Health Nursing $3,480-54,380 per 
annum. 

Full Civil Service benefits, including 
liberal sick leave with pay, three 
weeks vacation with pay and pension 
privileges. 

Apply stating training, experience and age to: 

THE DIRECTOR, 

PUBLIC HEALTH NURSING SERVICES, 

320 SHERBROOK STREET, WINNIPEG, MAN. 



GENERAL HOSPITAL 

ST. JOHN'S, NEWFOUNDLAND 
CANADA 

OPERATING ROOM SUPERVISOR 

Applications are invited for an Operating 
Room Supervisor to organize and admin- 
ister a new 12 room operating theatre and 
a recovery room. 

Qualifications must include postgraduate 
study in operating room administration and 
experience of not less than two years in 
operating room supervision. 
Must be eligible for registration in New- 
foundland. 

Liberal sick leave and annual leave 
policies. Salary open. 

Would be prepared to consider a 1 or 2-yr. 
contract. Transportation to Newfoundland 
will be paid on the basis of a minimum of 
one year's service. 

Position will be available in the Spring of 
1959. 

Applications with full details should be 

addressed to: 

DIRECTOR OF NURSING 

GENERAL HOSPITAL 

ST. JOHN'S, NEWFOUNDLAND, CANADA 



82 



THE CANADIAN NURSE 



NURSING WITH INDIAN AND 

NORTHERN HEALTH SERVICES 



"V **.•» i ir^' 



^< 



V« - 



.*fc .,*JtZt^^t ?'- 



• HOSPITALS 
+ NURSING STATIONS 
^gl^ A OTHER HEALTH CtNTBtS 



P^' 



OPPORTUNITIES 

REGISTERED HOSPITAL NURSES, PUBLIC HEALTH NURSES, 

AND CERTIFIED AUXILIARY NURSES 

for Hospital Positions and Public Health Positions in Outpost Nursing 
Stations, Health Centres and Field Positions in the Provinces, Eastern Arctic 
Northwest Territories and the Yukon Territory. 



SALARIES 



(1) 

(2) 
(3) 
(4) 

(5) 
(6) 
(7) 



(1) Public Health Nursing Supervisors: up to $5,220 depending upon 
qualifications and location. 

(2) Directors of Nursing in Hospitals: up to $4,950 depending upon 
qualifications and location. 

(3) Public Health Staff Nurses: up to $3,780 per year depending upon 
qualifications and location. 

(4) Hospital Staff Nurses: up to $3,540 per year depending upon 
qualifications and location. 

(5) Certified Nursing Assistants or Licensed Practical Nurses: up to 
$200 per month depending upon qualifications and location. 

• Room, Board and Laundry in residence at reasonable rates. 
Statutory holidays. Three weeks' annual leave with pay. Generous sick 
leave credits. Hospital-Medical and superannuation plans available. 

• Special pay and leave allowances for those posted to isolated areas. 

For interesting, challenging, satisfying work apply to — Indian and 
Northern Health Services at one of the following addresses: 



Regional Superintendent, 4824 Fraser Street, Vancouver, B.C. 

Regional Superintendent, 1 1412-1 28th Street, Edmonton, Alberta. 

Regional Superintendent, 735 Motherwell Building, Regina, Saskatchewan. 

Regional Superintendent, 803-9 Confederation Life Building, 457 Main Street, Winnipeg, 
Manitoba. 

Regional Superintendent, 4th Floor, Booth Building, 165 Sparks Street, Ottawa, Ontario. 
Zone Supervisor of Nursing, Box 493, North Bay, Ontario. 

Zone Superintendent of Indian Health Services, P.O. Box 430, Upper Town, 3 Buade Street, 
Quebec 4, P.O. 




Chief, Personnel Division, Department of National Health and Welfare, Ottawa, Ontario. 



J.ANL ARY. 1959 • Vol. 55. No. 1 



83 



+ 



THE 

CANADIAN 

RED CROSS 

SOCIETY 

offers interesting and 
challenging positions in 

OUTPOST NURSING 

PUBLIC HEALTH NURSING 

BLOOD TRANSFUSION 

SERVICE 

Salaries are in proportion to 
experience and qualifications. 

Transportation arranged 
under certain circumstances. 

Bursaries available for 
postgraduate studies. 

Group insurance, pension 
plan and other benefits. 

For information please contact.- 

NATIONAL DIRECTOR, NURSING SERVICES, 

THE CANADIAN RED CROSS SOCIETY 

95 WELLESLEY STREET EAST, 

TORONTO 5, ONTARIO 

+ + + + + + + + + + + + + 

Registered Nurses willing to 

serve as volunteer Home Nursing 

Instructors v/ill be welcomed by 

the Red Cross Branch 

in your community. 



VICTORIAN ORDER OF 
NURSES FOR CANADA . . . 

requires 

PUBLIC HEALTH NURSES 

for Staff and Supervisory positions in 
various parts of Canada. 

Applications will be considered from 
Registered Nurses without Public 
Health training but with University 
entrance qualifications. 

I -) 

I SALART, STATUS AND PROMO- 
TIONS ARE DETERMINED IN 
RELATION TO THE QUALIFICA- ' 
TIONS OF THE APPLICANT. I 



Apply to: 

Director in Chief, 

Victorian Order of Nurses 

for Canada 

5 BLACKBURN AVENUE 

Ottawa 2, Ont. 



PUBLIC HEALTH NURSES 
WANTED 

For the Municipal Nursing Service 
& for Staff positions in Health Units. 

Salary range — $3,000 - $4,140 
per annum, depending on quali- 
fications & experience. 

Excellent holiday, sick leave & 
pension programs. 

Apply to 

DIRECTOR, PUBLIC HEALTH NURSING, 

DEPT. OF PUBLIC HEALTH, 

GOVERNMENT OF ALBERTA, 

ADMINISTRATION BLDG., 

EDMONTON, ALBERTA. 



84 



THE CANADIAN NURSE 



DIRECTOR OF NURSING 

required for 

1 OO-bed hospital; located in busy town of 4000 people 

very well equipped hospital oflFering a challenging future 

to one qualified to meet the requirements. 

Salary offered & qualifications desired are in accordance 
with suggested R.N.A.O. schedules. 

Apply: ADMINISTRATOR, LADY MINTO HOSPITAL, COCHRANE, ONTARIO. 



SUPERVISOR 

MEDICAL AND SURGICAL 

SUPPLIES 

THE QUEEN ELIZABETH 

HOSPITAL 

TORONTO, ONTARIO 

519-beds, good salary, 40-hr. 
work week, pension, 1-mo. 
vacation & 8 statutory holidays. 

Excellent living accommodation 
if desired. 

APPLY: ADMINISTRATOR 



SARNIA, ONTARIO 

CANADA'S CHEMICAL 
VALLEY 

AND 

PORTAL TO OUR BEAUTIFUL 

BLUEWATER COUNTRY 

You will enjoy being a part of this 
progressive, growing community 
as an employee of the Sarnia 
General Hospital. 

Positions available in all 

services for 

REGISTERED NURSES 

Excellent Personnel Policies include 
40-hour week, 3 weeks paid annual 
vacation, 9 statutory holidays. 

Salary range $2,938 to $3,640 

Please apply to: 

PERSONNEL DIRECTOR 

SARNIA GENERAL HOSPITAL, 

SARNIA, ONTARIO 



REGISTERED NURSES 




OFFERED 




Exceptional opportunity by progressive 


& fully 


accredited 200-bed Ohio Hospital. 


Regular 


salary increases, splendid housing & 


living 


quarters, paid tuition In college, paid vacations | 


& liberal sick leave. Address all 


corre- 


spondence in confidence to 




DOCTORS HOSPITAL, 12345 




CEDAR ROAD, CLEVELAND HEIGHTS 


6, 


OHIO. PERSONNEL DIRECTOR. 





DIETITIAN 

(Immediately) 

for 250-bed hospital, with School 
of Nursing. 

Salary commensurate with training 
and experience. 

Apply fo; 

Miss Noreen Flanagan, AcJministrator, 

MUNICIPAL HOSPITAL, MEDICINE HAT, 

ALBERTA 



JANUARY. 1939 • Vol. 55. No. 1 



85 



NEW BRUNSWICK 

ASSOCIATION OF REGISTERED NURSES 

Invites applications for the position of 

NURSING SCHOOL ADVISER 

for further information apply to: The Secretary-Registrar 

The New^ Brunsyvick Association of Registered Nurses 

23 1 Saunders Street — Fredericton, N.6. 



APPLICATIONS ARE REQUESTED BY 

WOODSTOCK GENERAL HOSPITAL 
FOR HEAD NURSE, MEDICAL FLOOR 3-11 
ALSO GENERAL STAFF NURSES 
/ 5 DAY WEEK, GOOD PERSONNEL POLICIES 

APPLY TO: DIRECTOR OF NURSING, WOODSTOCK GENERAL HOSPITAL, 
WOODSTOCK, ONTARIO 



REGISTERED NURSES 

Required by several of the nineteen (19) hospitals in Saskatchewan's 
beautiful Northwest. This area has excellent recreational facilities. 
General Duty Nurses: 40-hr. 5-dy. wk. with generous paid holidays. Excellent 
residence facilities. Salary $260 — $320. 

Superintendent of Nursing: Several required. Wonderful working conditions 
with first class residence facilities. Salary $300 — $385. 

Further information con be obtained, & application submitted to Co-ordinafor, 
REGIONAL HOSPITAL COUNCIL, 1165 MAIN STREET, NORTH BATTLEFORD, SASKATCHEWAN. 



THE PETERBOROUGH CIVIC HOSPITAL 

REQUIRES 

NURSES FOR GENERAL DUTY IN ALL SERVICES, INCLUDING 
OPERATING ROOMS & DELIVERY ROOMS. 

For further information write: 

THE DIRECTOR OF NURSING 

PETERBOROUGH CIVIC HOSPITAL, PETERBOROUGH, ONTARIO 



86 THE CANADIAN NURSE 



GRADUATE STAFF NURSES — YOU WILL LIKE IT HERE 

Opportunities for men & women on the service of your choice. A 953-bed 

teaching hospital with a friendly atmosphere, well planned orientation program, 

active graduate nurse club, cultural advantages & excellent transportation 

facilities. 

Starting salary: $325 per mo. 6 holidays, sick leave, 3 wk. vacation. 

For furfher details write: 
Director — Nursing Service, University Hospitals of Cleveland, Ohio. 



UNIVERSITY HOSPITAL 

SASKATOON, SASKATCHEWAN 

Requires 
General Staff Nurses for Medical, Surgical, Obstetrical and Pediatric Services. 
Forty hour week. Salary $250 to $290 gross per month. Differential for 
evening and night duty. Residence accommodation if desired. 

Apply to: 

DIRECTOR OF NURSING, UNIVERSITY HOSPITAL, 

SASKATOON, SASKATCHEWAN 



GRADUATE NURSES - SUBURBAN TORONTO 

Are invited to enquire re: employment opportunities in a well-staffed new 
1 25-bed hospital in suburban west Toronto. General duty salary range: 
$240-$290 per mo. Residence accommodation optional. Personnel manual 
forwarded on request. Enquire to: 

DIRECTOR OF NURSING, HUMBER MEMORIAL HOSPITAL, 200 CHURCH ST. WESTON, 
TORONTO 15, ONTARIO. CHerry 4-5551. 



GENERAL DUTY NURSES 

FOR ALL DEPARTMENTS 

Gross salary $255 monthly ($1 17.50 bi-weekly) if registered in Ontario, $235 
monthly ($108.20 bi-weekly) until registered. Annual increment $10 monthly 
($4.60 bi-weekly) for three (3) years. Rotating periods of duty, 40-hr. per wk., 
8 statutory holidays. 14-days vacation & 1 2-days leave for illness with pay after 
1-yr. Pension plan available. Ontario Hospital Insurance with Blue Cross 
supplemental & Physicians' Services Incorporated, partial payment by hospital. 

APPLY 
DIRECTOR OF NURSING, GENERAL HOSPITAL, OSHAWA, ONTARIO. 



JANUARY. 1959 • Vol. 55. No. 1 87 



CANADA'S CHEMICAL VALLEY 

SARNIA, ONTARIO 

DIRECTOR OF NURSING SERVICES 

Required for modern, fully approved (JCAH) 300-bed well equipped hospital. 
This progressive industrial city of 45,000 is growing; it is located on the shores 
of Lake Huron and the St. Clair River. 

The hospital has approved schools for nurses, laboratory technologists, x-ray 
technicians, and is approved for intern training. 

Qualifications for applicants include registration in Ontario, at least a 
Bachelor's degree in administration, and successful experience in the field of 
nursing education as well as in administration. 

For more defails and liferature concerning the position and Sarnia, write to.- 

PERSONNEL DIRECTOR 

SARNIA GENERAL HOSPITAL, SARNIA, ONTARIO 



THE JOHNS HOPKINS 
HOSPITAL 

SCHOOL of NURSING 

Offers to qualified Registered Nurses 
a 16-week supplementary course in 

OPERATIVE ASEPTIC TECHNIC 

with instruction and practice in the 
general surgical, neurosurgical, plastic 
orthopedic, gynecologic, ophthalmolo- 
gic, urologic and ear, nose and throat 
operating room services. Maintenance 
and stipend are provided. 

For information write to: 

Director, School of Nursing 

The Johns Hopkins Hospital 

Baltimore 5, Maryland, U.S.A. 



THE WINNIPEG 
GENERAL 
HOSPITAL 

IS RECRUITING 

1. CLINICAL SUPERVISORS 
IN MEDICINE & SURGERY 

2. GENERAL DUTY NURSES 
FOR ALL SERVICES 

Please send applications direct to: 

THE DIRECTOR OF NURSING, 
THE WINNIPEG GENERAL 

HOSPITAL, 
WINNIPEG 3, MANITOBA. 



THE CANADIA.X NURSE 



...when can I take 

my baby off formula? 



Most doctors feel it is wisest to 
continue the infant's evaporated 
milk formula for six months, ad- 
justing it from time to time to 
meet his changing needs. Evapo- 
rated milk processing makes it 
easier to digest than fresh milk. 
This is an important point, since 
digestive upsets and diarrheas are 
more difficult to treat and poten- 
tially more serious during infancy. 

During baby's important first six 



months, you can count on the 
known digestibility of his individ- 
ual evaporated milk formula to 
give him basic growth protection. 
It is far wiser to give baby this 
protection than to try to turn him 
into an adult too early! 

@mation 

^^h^/"FROM CONTENTED COWS" 

Optimum prescription- \ i«tm»ni^ 
quality in today's trend to the e>vSlil-ll-. 
individualized formula. 




FEBRUARY. 1959 • VOL. 55, No. 2 



THE CANADIAN NURSE 



VOLUME 55 



NUMBER 2 



FEBRUARY 1959 



92 Between Ourselves 

94 New Products 

96 English or French? 

1 03 A Dream Comes True Clara Van Dusen 

106 Gastrointestinal Intubation W. Grobin 

1 09 Duodenal Ulcer Helen Lemieux 

114 Peptic Ulcer „ Carole Eldridge 

1 20 Pyloric Stenosis Adeline Pavan 

1 23 Nursing Care in 

Hemorrhoidectomy Patricia Rowland 

1 28 Mission to Japan Hazel F. Naudett 

1 32 Nursing Profiles 

1 34 In Memoriam 

1 35 The Past has a Future Albert W. Wedgery 

1 39 The Master Plan of Rotation Margaret M. Street 

1 43 L'Organisation et la Conduite 

d'une Assemblee „ Patricia Duplain 

1 64 Nursing Across the Nation 

1 68 Le Nursing a travers le pays 

1 62 Sawdust Beds Beulah V. Bourns 

1 64 The Registrar Ann F. Gavin 

1 64 News Notes 

169 Employment Opportunities 



Editor and Business Manager 
MARGARET E. KERR, M.A., R.N. 

Assistant Editor 
JEAN E. MacGREGOR, B.N., R.N. 



Subscription Rates: Canada & Bermuda: 6 months $1.75; one year, $3.00; two years, $5.00. 

Student nurses — one year, $2.00; three years, $5.00. U.S.A. & foreign: one year, $3.50; two years, $6.00. 

In combination with the American Journal of Nursing or Nursing Outlook: one year, $8.00. 

Single copies, 35 cents. 

Make cheque and money orders payable to The Canadian Nurse 

Change of address: Four weeks' notice and the old address as well as the new are necessary. 

Not responsible for Journals lost in mail due to errors in address. 

Authorized as Second-Class Mail, Post Office Department, Ottawa. 

Advertising Representatives: W. F. L. Edwards & Co. Ltd., 34 King St. E., Toronto 1, Ont. 

Walter Slack, 801 Public Ledger Building. Philadelphia 6, Pa. 

Member of Canadian Circulations Audit Board. 

1522 Sherbrooke Street West, Montreal 25, Quebec 



The views expressed 
in the various articles 
are the views of 
the authors and 
do not necessarily 
represent the policy 
or views of 

The Canadian Nurse 
nor of the Canadian 
Nurses' Association. 



90 



THE CANADIAN NURSE 



■oo) 



leoo^ 



I HIS little housewife had a 
problem — sweet-tooth Hubby on 
a sweet-free diet. (And beginning 
to get nervous about it.) She 
tried everything. Fancy salads. 
Bigger helpings. But Hubby's 
frown darkened by the day. Then 
one day she read in a magazine 
about a discovery, a new 
non-caloric sweetener. One that 
she could actually cook and bake 
with — in any food, at any 
temperature. One which gave 
the perfect taste of sugar — with 
no bitter aftertaste in ordinary 
use. That night there were 
cookies, pudding, coffee — sweet 
coffee — and a big, big smile across 
the table . . . 



( Sliott ) 



. . . and so she 
started using 



Sucaryl 

(Cyclamate, Abbott) 



® 



For samples 

and 

recipe booklets, 

write 

Abbott 

Laboratories 

Montreal. 




FEBRUARY, 1959 • VOL. 55, No. 2 



^etwee^ Oun^ciiAe^ 



Ever since the Alberta Association of 
Registered Nurses was first formed the pro- 
vincial office has occupied rented accommo- 
dation. As their work expanded they have 
moved from a corner of one room into offices 
with several rooms. Now, their moving days 
are over for a long time to come. In Novem- 
ber, their splendid new headquarters was of- 
ficially opened. Our cover picture depicts 
the front entrance. 

Though committees were responsible for 
decisions, the person most intimately con- 
cerned to see that all details were correct- 
ly adapted to make a functional working unit 
was our guest editor, Mrs. Clara Van 
Dusen. A graduate of Regina General 
Hospital, Mrs. Van Dusen alternated be- 
tween private nursing and general staff, with 
time out for a postgraduate course in 
Mothercraft, including infant care and feed- 
ing. She commenced her work with the 
Alberta Association in 1949 as registrar, 
assuming full responsibility for the associ- 
ation's work as executive director more 
recently. 

* * * 

With radio and television advertising so 
often lauding the capabilities of various 
products to relieve "acid indigestion" most 
lay people have at least some idea of the 
significance of the feeling of bloating, of 
fulness or of actual pain in the epigastric 
area. They are unaware, however, of the pos- 
sible relationship of these symptoms to 
lesions in other organs such as the gall- 
bladder, duodenum or appendix. All of these 
organs are supplied by branches of the same 
nerves that go to the stomach. The stomach 
is such a sensitive organ that it may react 
quite violently in sympathy with the 
neighboring organ. The first advice we 
should give any complainant, therefore, is 
that he or she should most certainly see her 
doctor rather than attempt self-medication. 
Taking any variety of antacid — even bicar- 
bonate of soda — can be very much over- 
done. 

Peptic ulcer is the commonest organic 
disease of the stomach and the first part of 
the duodenum. When for anv reason a small 



area of the mucous membrane in either 
organ is injured and becomes necrosed, the 
acid gastric juice digests that dead tissue 
just as it would act upon any piece of dead 
meat consumed in the course of a meal. Thus 
a hole or depression is made in the wall of 
the organ. If uncared for it may extend for 
varying depths. 

The role of the gastric juice in pro- 
ducing a peptic ulcer is easy to understand. 
The more difficult question is to discover 
what caused the necrosis in the first place. 
Since the ulcers occur most frequently in 
persons who are nervous, restless, irritable, 
prone to worry and upset by strain, the con- 
sensus today is that these factors may com- 
bine to produce a spasm in a small artery in 
the wall of the stomach or duodenum. Lack- 
ing nutriment from the blood, the small area 
becomes necrotic and an ulcer is the end 
result. 

Aledical treatment always comes first with 
these patients. The primary aim is to give 
the ulcer an opportunity to heal. The de- 
scriptions given in the articles by Carole 
Eldridge and Helen Lemieux present a 
clear picture of the importance of thoughtful 
nursing care as an adjunct to the rest, food 
and medication ordered by the physician. 

* * * 

Last summer Hazel Naudett was the 

representative of Canadian nurses on the 
special tour of Japan arranged under the 
auspices of the United Nations Educational, 
Scientific and Cultural Organization. Since 
her return, Miss Naudett has been besieged 
with invitations to tell of her experiences. 
We felt it was of interest to nurses in all 
parts of Canada as well so asked her to 
share her story with all of us. You will find 
it interesting reading. 

* * * 

We have been inclined to think of the 
province of Saskatchewan as an agricultural 
area, far removed from the field of industry. 
As an instance of how times have changed, a 
recent survey reveals that there are now 
thirteen nurses employed full-time in occupa- 
tional health programs, with four others en- 
gaged in this work on a part-time basis. 



The days that make us happy make us 
wise. — John Masefield 



Peace is happiness digesting. 

— Victor Hugo 



92 



THE CANADIAN NURSE 




diaper rash? 



DESITIN OINTMENT 
of coursed 



'soothing, protective, 
anti-irritant Desitin Ointment 
has been the answer for 
preventing and clearing up 
diaper rash in millions 
of babies for over 
30 years. 



We would be pleased 

to send SAMPLES on request. 

DESITIN CHEMICAL COMPANY 

Sole Canadian Representative and Distributor 

LESLIE A. ROBB 

5 Traymore Crescent, Toronto 9, Canada 



FEBRUARY, 1959 • VOL. 55. No. 2 



93 



Edited by DEAN F. N. HUGHES 

Published Through Courtesy of Canadian Pharmaceutical Journal 

CHLORAMMON ENTRIL 
Description — Each enteric tablet (entril) contains: Ammonium chloride 71/2 gr. 
Indications — The treatment of cardiac edema, Meniere's syndrome, pyuria, premen- 
strual tension. 

Administration — Six to 12 tablets a day as prescribed. 

KANTREX 

Manufacturer — Bristol Laboratories of Canada Limited, Montreal. 

Description — Kanamycin sulfate, a bactericidal antibiotic for control of infections 
caused by a wide variety of pathogenic organisms, both Gram positive and Gram 
negative. 

Indications — Especially in the treatment of infections caused by staphylococci 
resistant to other antibiotics and in infections of the urinary and respiratory tract. The 
drug is also suggested for presurgical intestinal antisepsis since it is poorly absorbed 
from the gut when given orally. 

Has not shown cross-resistance with any other major antibiotic. 

Administration — Intramuscularly in a total dose of 1 to 2 grams daily in 2 to 4 divided 
doses. 

PROSTIGMIN TIMESPAN 

Manufacturer — Hoffman-La Roche Ltd., Montreal. 

Description — Each capsule-shaped sustained release tablet contains 45 mg. neostig- 
mine bromide, (the dimethyl-carbamic ester of 3-hydroxyphenyl-trimethyl-ammonium 
bromide). Offers a more prolonged effect than does the regular form of prostigmin. 

Indications — Myasthenia gravis. 

Contraindications — Asthma; mechanical intestinal or urinary obstruction. 

Administration — Dosage should bo individualized according to the patient's re- 
sponse. For control of symptoms in most myasthenia gravis patients, 1 to 3 tablets will 
be sufficient every 4 hours or more. However, the needs of certain individuals may 
vary markedly from this average requirement. 

TESSALON SUPPOSITORIES 

Manufacturer — Ciba Company Ltd., Montreal. 

Description — Tessalon (Benzononatine) for rectal administration, 50 mg. and 100 mg. 
Well-tolerated non-narcotic antitussive. Acts on sensory receptors in the respiratory 
passages, lungs and pleura, and, it has a central inhibitory action on the cough reflex. 
It does not impair expectoration, suppress voluntary cough or inhibit the respiratory 
centre. 

Indication — In acute and chronic respiratory diseases for control of cough. 

Administration — Adults: 100 mg. suppository 2 or 3 times daily. 

Children: 50 mg. suppository 2 or 3 times daily. 

When needed, may be given in higher dosages with safety. 

ULTANDREN 

Manufacturer — Ciba Company Ltd., 1235 McGill College, Montreal. 

Description — Fluoxymesterone, a new testosterone derivative; provides the potency 
of injected testosterone esters and up to 5 times that of oral methyltestosterone. 

In addition to androgenic effect, it promotes protein anabolism and prevents loss 
of calcium. The anabolic effect appears to be relatively greater than its androgenic 
effect, and, in recommended dosage, the frequency and degree of virilization in females 
has been less than with other testosterones. 

Indications — In men or women in all cases where an androgenic-anabolic effect is 
required. 

In the female: Menopausal symptoms, menorrhagia, metrorrhagia, premenstrual 
tension, functional dysmenorrhea and inoperable mammary cancer. 

In the male: Symptoms of the male climacteric and hypogonadism. 

In both sexes: Osteoporosis and where tissue repair and other anabolic effects are 
desired, i.e., in burns, paraplegia, catabolism produced by long-term cortisone therapy, 
delayed healing of fractures, chronic malnutrition, debilitating diseases and convales- 
cence. 

Administration — In conditions where a specific sexual effect is desired: initial dosage 
is usually 2-4 mg. (up to 10 mg. in hypogonadism); maintenance dosage is 1-2 mg. 
daily. 

In conditions were anabolic effects are desired: initial dosage is 4-10 mg. daily 
(plus high protein diet); maintenance dosage may be as low as 2-4 mg. daily. 

In malignancies and where intensive androgen therapy is required: average daily 
dosage is 20 mg.; once the optimum dosage is ascertained it should be adhered to. 
The Journal presents pharmaceuticals for information. Nurses understand that only a physician may prescribe. 

94 THE CANADIAN NURSE 



McMASTER UNIVERSITY 
School of Nursing 

DEGREE COURSE IN BASIC NURSING (B.Sc.N.) 

A Four-Year Course designed to prepare students for oil branches of 
community and hospital nursing practice and leading to the degree. 
Bachelor of Science in Nursing (B.Sc.N.). It includes studies in the human- 
ities, basic sciences and nursing. Bursaries, loans and scholarships are 
available. 

DEGREE COURSE IN SCIENCE TEACHING 
FOR GRADUATE NURSES (B.Ed.N.) 

A Two-Year Course designed to prepare graduate nurses to teach basic 
sciences in schools of nursing and leading to the degre, Bachelor of 
Education in Nursing (B.Ed.N.) It includes studies in the humanities, the 
physical, social and biological sciences, teaching and nursing education. 
Bursaries of Six Hundred Dollars each are offered in both years of this 
Course. 

For additional information, write to: 

School of Nursing, 
McMaster University, Hamilton, Ontario. 



ENGLISn OR FRMCn? 

Everyone is aware by now of the fact that 
two separate issues of our Journal will be 
published each month commencing with the 
June, 1959 number. This important milestone 
in the history of the nursing profession in 
Canada will be marked by several changes. 
A smart new cover design for both issues has 
been approved. We are departing from the 
dark blue color on the cover that has identi- 
fied our Journal for the past 20 years. 

Arrangements have been made respecting 
publication dates. The Canadian Nurse, as 
the senior issue, takes precedence. It will 
come from the press at tlie beginning of the 
month. L'Infirmiere canadienne will follow 
in approximately two weeks. 

Currently, the separate mailing list for 
those who desire to receive the French issue 
is being built up. The A.N.P.Q. is helping 
us very materially by indicating with an as- 
terisk those of its members who are English 
and who will, therefore, be put on the mail- 
ing list for The Canadian Nurse. All other 
subscribers in the province of Quebec will 
automatically be placed on the list of those 
who will receive the French issue. Any 



among the latter group who wish to receive 
the English issue instead are requested to 
notify the Journal office in writing before 
April 15, 1959. Please give us your registra- 
tion number as well as your full name and 
address to avoid the possibility of errors. 

Similarly, L'Infirmiere canadienne will 
be available to any subscriber who wishes 
to receive the Journal in French. All that 
will be necessary is to notify us in writing, 
again giving the essential information for 
identification purposes : Your name, address, 
province of registration and registration 
number. 

Of course, changes can be made later at 
any time. But every nurse who wishes to 
make a change in the above-mentioned listing 
must notify us by April 16, 1959 if she 
wishes to receive the June issue. 

Such changes ivill only be made ivhen they 
are requested in zvriting. The address to 
which all of these letters should be sent is : 

The Canadian Nurse Journal, 
1522 Sherbrooke Street West, 
Montreal 25, Quebec. 



FEBRUARY, 1959 • VOL. 55, No. 2 



95 



DALHOUSIE UNIVERSITY 

School of Nursing 

COURSES OFFERED 

1959- 1960 

1. Degree Course in Basic Professional Nursing 

Candidates for the degree of Bachelor of Nursing are required to complete 
2 years of university work before entering the clinical field, and one year 
of university v/ork following the basic clinical period of 30 months. On 
completion of the course the student receives the Degree of Bachelor of 
Nursing and the Professional Diploma in either Teaching in Schools of 
Nursing or Public Health Nursing. 

2. Degree Course for Graduate Nurses 

Graduate nurses who wish to obtain the degree of Bachelor of Nursing are 
required to complete the three years of university work. 

3. Diploma Courses for Graduate Nurses 

(a) Public Health Nursing 

(b) Teaching in Schools of Nursing 

For further informafion apply to.- 

DIRECTOR, SCHOOL OF NURSING 
DALHOUSIE UNIVERSITY, HALIFAX, N.S. 



QUEEN'S UNIVERSITY 
SCHOOL OF NURSING 

COURSES OFFERED 

Undergraduate 

Degree Course, 5 years leading to 
BNSc. Degree 

Graduate Nurses 
a. Degree Course, two years. 
•b. Diploma Courses, one year. 
Public Health Nursing 
or 

Teaching and Supervision in Schools 
of Nursing. 

For information apply to: 

DIRECTOR 

SCHOOL OF NURSING, 

QUEEN'S UNIVERSITY 

KINGSTON, ONTARIO 



THE MOUNTAIN 
SANATORIUM 

HAMILTON, ONTARIO 

TWO-MONTH 

POSTGRADUATE COURSE 

IN THE IMMUNOLOGY, 

PREVENTION & TREATMENT 

OF TUBERCULOSIS 

This course is especially valuable 
to those contemplating Public 
Health, Industrial, or Tuberculo- 
sis Nursing. 

For further infortnation apply to: 

Director of Nursing, 

Mountain Sanatorium 

Hamilton, Ontario. 



96 



THE CANADIAN NURSE 



The New York Polyclinic 

MEDICAL SCHOOL AND HOSPITAL • Organized 1 881 

The Pioneer Postgraduate Medical Institution in America 

We announce the following Courses (Six Months Duration) for 
Qualified Graduate Nurses: 

N. 1. Operating Room Management and Technic 

N. 2. Medical-Surgical Nursing — Supervising and Teaching 

N. 3. Organization and Management of Out-Patient Department 

(Clinics In all branches of Medicine, Surgery — and Allied Specialties) 

Courses include lectures by the Faculty of the Medical School and Nursing 
School; principles of teaching; principles of supervision, teaching and 
management of the specialty selected. 

Positions available to graduates of these courses. 

Full maintenance is provided 

For information address: 
Director of Nursing Education, 345 W. 50th St., New York 19, N.Y. 



PSYCHIATRIC COURSE 

for 

REGISTERED NURSES 

The Nova Scotia Hospital offers to 
qualified Registered Nurses a six- 
month certificate course in Psychiatric 
Nursing. 

• Classes in March and September. 

• Remuneration. 

• Preference given to Nova Scotia 
applicants. 

For further information apply to : 

Superintendent of Nurses 
Nova Scotia Hospital 
Drawer 350 
Dartmouth, Nova Scotia 



NOVA SCOTIA SANATORIUM 

KENTVILLE N.S. 

Offers to Graduate Nurses a Six- 
Month Course in Tuberculosis Nursing, 
including Immunology, Prevention, 
Medical & Surgical Treatment. 

1. Full series of lectures by Medical 
and Surgical staff. 

2. Demonstrations and Clinics. 

3. Experience in Thoracic Operating 
Room and Postoperative Unit. 

4. Full maintenance, salary & all staff 

privileges. 

5. Classes start May 1st and Novem- 
ber 1st. 



For information apply to : 

SUPT. OF NURSES, NOVA SCOTIA 
SANATORIUM, KENTVILLE, N.S. 



FEBRUARY, 1959 • VOL. 55, No. 2 



97 



THE WINNIPEG GENERAL 
HOSPITAL 

Offers to qualified Registered Grad- 
uate Nurses the following oppor- 
tunities for advanced preparation : 

1. A six month Clinical Course in 
Obstetrics. 

2. A six month Clinical Course in 
Operating Room Principles and 
Advanced Practice. 

These courses commence in January 
and September of each year. Main- 
tenance is provided. A reasonable sti- 
pend is given after the first month. 
Enrolment is limited to a maximum of 
six students in each course. 

For further information please 

tvrite to: 

DIRECTOR OF NURSING 

GENERAL HOSPITAL 
WINNIPEG, MANITOBA 



A COURSE IN 

ADVANCED OPERATING ROOM 

TECHNIQUE AND 

MANAGEMENT 

is offered by 

THE MONTREAL 
G^ERAL HOSPITAL 

to 

Qualified registered nurses. 

Classes of 6 months' duration 

are admitted September and March 

and are limited to 6 students. 

For further information writ* to: 

THE DIRECTOR OF NURSING, 

THE MONTREAL GENERAL HOSPITAL, 

MONTREAL 25, QUE. 



WILLS EYE HOSPITAL 
Philadelphia^ Penna. 

The largest eye hospital in the 
United States, offers a six-month 
course in Nursing Care of the Eye to 
Graduates of Accredited Nursing 
Schools. Operating Room Training is 
scheduled in the course. 

• $205 per month for the first four 
months. $215 per month for the last 
two months. 

• REGISTRATION FEE is $20 

• Course starts March 15 & Septem- 
ber 15. Ophthalmic Nurses in great 
demand for hospital eye departments, 
operating rooms & ophthalmologists' 
offices. 

For information write to : 

Director of Nurses, 

Wills Eye Hospital, 

1601 Spring Garden Street, 

Philadelphia 30, Penna. 



THE JOHNS HOPKINS 
HOSPITAL 

SCHOOL of NURSING 

Offers to qualified Registered Nurses 
a 16-week supplementary course in 

OPERATIVE ASEPTIC TECHNIC 

with instruction and practice in the 
general surgical, neurosurgical, plastic 
orthopedic, gynecologic, ophthalmolo- 
gic, urologic and ear, nose and throat 
operating room services. Maintenance 
and stipend are provided. 

For information write to : 

Director, School of Nursing 

The Johns Hopkins Hospital 

Baltimore 5, Maryland, U.S.A. 



96 



THE CANADIAN NURSE 



ROYAL 
VICTORIA 
HOSPITAL 

SCHOOL OF NURSING 

MONTREAL, QUEBEC. 

Postgraduate Courses 

1. (a) Six month clinical course in Obsfet- 
rical Nursing. 
Classes — September and February. 

(b) Two month clinical course in Gyneco- 
logical Nursing. 

Classes following the six month 
course in Obstetrical Nursing. 

(c) Eight week course in Care of the 
Premature Infant. 



2. Six month course in Operating Room 
Technique and Management. 
Classes — September and March. 



3. Six month course in Theory and Practice 
in Psychiatric Nursing. 
Classes — September and March. 



Complete maintenance or living-out allow 
once is provided for the full course. 

Salary — a generous allowance for the 
last half of the course. 

Graduate nurses must be registered and in 
good standing in their own Provinces. 

For informot/on and details of fhe courses, 
apply fo: — 

Miss H. M. Lament, B.N. 

Director of Nursing, 

Royal Victoria Hospital, 

Montreal, P.Q. 



AS LONG AS THERE ARE 

PARTICULAR NURSES 

THERE WILL BE A DEMAND FOR. — 

BLAND'S TAILORED 

UNIFORMS 

JUST WRITE TO US, AND SEE 

HOW EASY IT IS TO HAVE THEM— 




No. 1599 
in the finest of Cottons 

Made and Sold only by 

BLAND AND COMPANY 

2048 Union Ave., Montreal, Canada 



FEBRUARY. 1959 • VOL. 55, No. 2 



99 



MONTREAL 

NEUROLOGICAL 

INSTITUTE 

McGILL UNIVERSITY 

GRADUATE COURSE 

in 

NEUROLOGICAL AND 

NEUROSURGICAL NURSING 

AND OPERATING ROOM 

TECHNIQUE 

Classes: Feb. 1 & Oct. 1 

One half staff salary is paid during 
course. Students may live in or out. 

For information apply: 

MISS E. C. FLANAGAN, B.A., R.N. 

Director of Nursing, 

3801 University St. 

Montreal, Que. 



COURSES 

FOR 

GRADUATE NURSES 

In various clinical fields, 
beginning March 9, June 1, 
August 24, and November 
16, 1959. 

Room, meals, laundering of 
uniforms, and honorarium 
provided. 

Apply to: 

DIRECTOR, 

COOK COUNTY SCHOOL 

OF NURSING, 

DEPT. C, 1900 WEST POLK ST., 

CHICAGO 12, ILLINOIS 



THE NATIONAL HOSPITAL 

QUEEN SQUARE 

London, W.C.I 

and 

MAIDA VALE HOSPITAL 

London W.9, England 

(Institute of Neurology, University of 
London) 

Postgraduate Nursing Education for 
Medical Neurology & Brain Surgery 
One year courses are open to Nurses on 
the General Register with good educational 
background. 

3 mo. full time instruction in the school 
under guidance of the Sister Tutor assisted 
by a teaching staff of senior neurologists 
& neuro-surgeons. 

8-mo. clinical experience, 1 mo. vacation. 

Certificate & badge of the hospital awarded 
to successful students. Staff nurses' salary 
paid throughout the year. This work has a 
special appeal to nurses interested in 
research & the humanitarian aspect of 
nursing. 

For further particulars apply to the Matron, 

THE NATIONAL HOSPITAL 



CHILDREN'S HOSPITAL 
OF WASHINGTON, D. C. 

OFFERS 

Registered Nurses a 16-v/k. supple- 
mentary program in pediatric nursing. 
Admission dates. May 6, September 1, 
1959, January 5, May 3, August 30, 
1960. 

For complete information write to-. 

DIRECTOR OF NURSING, 
21 25-1 3th STREET, N.W., WASHINGTON 9, D.C. 



Epilepsy, known in ancient times as the 
Sacred Disease, was treated by many with 
preparations from mistletoe. The origin of 
this superstition is based on the fact that the 
mistletoe does not fall from the branches 
of the tree to which it is rooted. It was 
hoped that the epileptic who used the mistle- 
toe preparation would develop the same prop- 
erty, i.e., not fall to the ground. 
* * * 

Sympathy is never wasted except when you 
give it to yourself. 



100 



THE CANADIAN NURSE 



3 






New 

5th 

Edition! 



Anthony ANATOMY AND 
PHYSIOLOGY LABORATORY MANUAL 

Adaptable for use with any text on anatomy and physiology, this new manual 
is designed to help students understand the basic facts and principles related 
to the human body. All of the exercises in this new edition have been 
written in an entirely new scientific format which encourages students to 
work on their own without help from the instructor. The procedures require 
basic skills and since simple equipment is used, little time is required to set 
them up. The equipment needed is listed at the beginning of each exercise 
and sources of supplies are suggested. The exercises allow great flexibility 
— many can be used as demonstrations, some as guides and some as quizzes. 

By CATHERINE PARKER ANTHONY, B.A., M.S., R.N., Assistant Professor of Nursing, 
Science Department, Frances Payne Bolton School of Nursing, Western Reserve University. 
Just Published. 5th edition, 356 pages 7%" x lOVi", 148 illustrations. Price, $3.50. 



New 

5th 

Edition! 



Karnosh-Mereness 
PSYCHIATRY FOR NURSES 

Written by two well qualified authors, PSYCHIATRY FOR NURSES is 
a clear, understandable presentation of the nurse's role in the care of 
psychiatric patients. Incorporating all the recent advances in the field, it 
helps students to understand the prevention, cause, treatment and rehabilita- 
tion of the mentally ill. This edition covers personality development, the 
development of defense mechanisms, cause and classifications of mental 
illness and the various therapies in use at the present time. The authors 
discuss nursing care for each type of mental illness, legal aspects of 
psychiatry and mental hygiene. 

By LOUIS J. KARNOSH, B.S., Sc.D., M.D., Clinical Professor of Nervous Diseases, School 
of Medicine, Western Reserve University; and DOROTHY MERENESS, Ed.D., R.N., Director 
of the Psychiatric-Mental Health Nursing Program, New York University. New. 1958, 5fh 
edition, 406 pages, 5Vi" x SVi" , 37 illustrations. Price, $4.50. 



New! 



Lockerby 

COMMUNICATION FOR NURSES 

Modern nursing no longer considers it sufficient for the nurse to master 
techniques alone. She must also learn and apply certain principles that will 
meet the emotional, social and spiritual needs of the patient. This book de- 
signed for "Professional Adjustment," "Nursing Arts" or "Communication" 
courses helps students develop the communicative skills necessary to become 
an articulate, perceptive and efficient nurse. In an informal, conversational 
style, the author orientates the nurse to her profession, covering not only 
the communicative processes but function in planning and giving nursing 
care, in the hospital and in professional growth as well. 

By FLORENCE K. LOCKERBY, A.B., M.A., Chairman of the Communication Deportment and 
Co-ordinator of General Education, Presbyterian — St. Luke's Hospital, School of Nursing, 
Chicago, III. New. 1958, 175 pages, 5Vi" x 81/2", illustrated. Price, $3.75. 



Gladly Sent to Teachers for Consideration as Texts 

Write to 

The C. V. MOSBY Company 

3207 Washington Boulevard, St. Louis 3, Missouri, U.S.A. 
Represented in Canada by 

McAINSH and Co. Ltd. -1251 Yonge St. -Toronto, Ontario 



FEBRUARY, 1959 • VOL. 55, No. 2 



101 



NEW PRODUCT 

in etje infections... 
broader antibacterial range 
greater therapeutic efficacij 



I 




.:,.:■:.— .■.L^.-....,.j..-.l 



OPHTHOC 



II :i 



CHLOROMYCETIN -/or effective, broad-spectrum therapy 
"...is effective against most gram-positive and gram-negative cocci and some gram> 

negative bacilli. It rarely produces dermatitis and resistant strains are uncommon.'" 
"...penetrates the noninflamed eye better than any other antibiotic, regardless of 

route of administration."* 

POLYMYXIN B— /or control of gram-negative invaders 
"...gram-negative bacilli are being isolated with increasing frequency from the con* 

junctiva...'" 

Polymyxin B "...is bactericidal against most gram-negative microorganiSitas..."* 

HYDROCORTISONE— /or anti-infiammatory , antiallergic action 
"Cortisone, hydrocortisone and ACTH, by altering the inflammatory responses of the 

body, cause a decreased amount of scarring and vascularization.'" 
"Hydrocortisone is about twice as potent gram for gram as cortisone, even when given 

locally."' 

indications: For topical use in ocular infections due to organisms sensitive to Chloromycetin 

or polymyxin B. 

ADMINISTRATION: Local application two to four times daily as required. 

packaging: ophthocort ointment contains 1% Chloromycetin® (chloramphenicol, Parke- 

Davis), 0.5% hydrocortisone acetate, and 6,000 units of polymyxin B sulfate per Cm., and is 

supplied in %-oz. tubes. 

HETERENCEs: (1) Perkins. E. S.: Praetitioner 178:676. 1957. (2) Queries and Minor Notes. J.A.ilJl, 

161:1032. 1966. (3) Smith. C. H.: Eye, Bar, Note & Throat Month. 34:680. 1955. (4) Blakiston's New 

Gould Medical Dictianary, ed. 2, New York, McGraw-Hill Book Comi>any. Inc., 19S6, p. 946. (6) Ostler. 

H. B., & Braley. A. E. : J. Iowa M. Soe. 44 :427, 1964. 

[): PARKE, DAVIS & CO., LTD • MONTREAL, P.Q. 



102 



THE CANADIAN NURSE 



m cflOflDiflo oufisf 

A MONTHLY JOURNAL FOR THE NURSES OF CANADA 
PUBLISHED BY THE CANADIAN NURSES' ASSOCIATION 



VOLUME 55 



NUMBER 2 



MONTREAL, FEBRUARY 1959 




A Dream Comes True 



THERE IS A SENSE of real accomplish- 
ment when a goal is reached. All 
the long weary hours of planning, the 
countless meetings of committees, the 
infinite details of innumerable dis- 
cussions fade into nothingness as the 
curtain rises on a new chapter in our 
Association's history. The wish, the 
dream, toward the realization of which 
so much effort has been expended, is 
at last a thrilling reality. 

November 12, 1958 will be recorded 
in the annals of the Alberta Associ- 
ation of Registered Nurses, and in the 
hearts of its thousands of members, 
as the day when a dream came true. 
Then it was that the splendid new 
three-story building at 10256-1 12th 
Street, Edmonton, was declared official- 
ly open. Then it was that Miss 
Margaret M. Street, President, assist- 
ed by other officers of the Association, 
conducted appropriate ceremonies in 
the presence of representatives of the 
provincial and civic governments, the 
University of Alberta, the Canadian 
Medical Association (Alberta Divi- 
sion), the Associated Hospitals of 
Alberta, and nurses from all over the 



province. It was a proud moment for 
one of the charter members of 1916, 
Miss Lottie Hunter, when she unveiled 
the bronze plaque : "Dedicated to Our 
Professional Heritage and to Continu- 
ing Growth Through Service." This 
plaque is now proudly viewed by all 
members who enter the reception area. 
Seventh of the provincial associations 
to own their administrative head- 
quarters, third to have constructed 
their own building, the nurses of 
Alberta are proud of the fact that this 




(David Miller — Edmonton) 

Officially Open 



FEBRUARY. 1959 • VOL. 55, No. 2 



103 



entire project, valued at approximately 
$100,000, has been financed through 
the gradual accumulation and careful 
husbanding of the Association's funds. 

Designed by Mr. Nicholas Flak 
and erected by Murmac Construction 
Limited, the building consists of three 
floors and is as practical and feminine 
as the modern nurse herself. It features 
a basic DU-AL block structure and at- 
tractive curtain wall construction with 
brick facing at the front exterior. The 
wall facing of baked pastel blue enamel 
on aluminum, with a touch of soft 
lemon yellow above the blue and silver 
entrance canopy, means there won't 
be any expenditures for paint repair 
jobs. The double-glazed glass windows 
assure warmth in winter and plenty 
of sunshine to accentuate the bright, 
cheerful atmosphere inside. In sum- 
mer, with the tightly-sealed double- 
glaze, the reverse effect is achieved. 

All the windows are draped in crisp 
"Terylene" material, a decorative note 
as pleasing from the outside as it is in 
the interior. 

Entering through the glass doors, 
a few steps lead up to the main floor 
and reception area. A snia]]. r-'.-c^^rd 




(David Mulct -Edmonton) 

1 lie Reception Area 

planter in the white arborite-topped 
desk, adds a cheerful spot of color 
to the area where the receptionist 
works under a well-lighted canopy. 
The hues throughout are soft sandal- 
wood alternating with turquoise. 

Immediately across from the recep- 
tion area is a waiting room with a 
louvred panel separating it from the 
general office. This use of louvred 
panelling gives an air of spaciousness 
to the office. A sette and armchairs, 
comfortably proportioned to the limited 
space, contribute to the pleasure of 
visitors who may choose to sample the 
magazines on the table. 



The sunshine that streams in the 
windows isn't any more cheery than 
the cooperative-minded staff who work 
in the general office under conditions 
approaching the ideal. The desk area 
has been so designed that it provides 
the most efficient tools to do the job 
that has to be done. Beyond the general 
office is another compact working space 
devoted to the accounting duties. 




(David Miller — Edmonton) 

The Executive Director's Office 

The executive director's office at the 
front of the building is designed with 
an eye to simplicity and function. 
Dominating the room is the overhung 
walnut desk made up in the modulaire 
style. A wall unit immediately back 
of the desk chair consists of a series 
of shelves, drawers, and filing space, 
all enclosed in panels with arborite legs 
in bronze-toned brass. The simply 
curtained glass-panelled east wall per- 
mits the maximum of light. This office 
affords the luxury of a synthetic Trilan 
Treebark rug in soft beige. With a 
small chesterfield settee, the room is 
sufficiently large to be used as a small 
conference area. An accordion-type 
door in the mahogany-panelled walls 
opens on a commodious clothes closet. 
As in all of the newer type of execu- 
tive offices, a small washroom with 
sink and toilet in seafoam green, com- 
pletes this accommodation. 

Framed by spacious windows at the 
rear of the building is the office of 
the registrar. Instead of four square 
walls, a much more pleasing effect is 
achieved with a thirty degree angled 
wall separating the registrar's office 
from the adjoining office, which will 
be occupied by the Nurses' Community 
Service staff. It it just another of those 
innovations that lends a distinctive air 
to the nurses' new building. Similar 
type walls are featured in other offices. 



104 



THE CANADIAN NURSE 



including the downstairs lounge. 

A general purpose room at the back 
of the building houses the mechanical 
equipment, such as addressograph, etc. 
Another small area is devoted to the 
business of sorting mail. 

In addition to the girls' modest, 
streamlined powder room, there is a 
staflf cloak room and additional toilet 
and washroom facilities for male and 
female visitors as well as a janitor's 
utility room. 

On the first floor, just below ground 
level, the stairs lead directly to the 
cloak room, a sensibly-sized space 
where one may sit down and remove 
outside winter footwear. Equipped with 
coat-hangers on either side, provision 
is also made to take care of gentlemen's 
hats. 

To the right of the stairway is the 
lounge. One wall is panelled in rotary- 
cut mahogany veneer in suntan finish. 
Underneath the glassed east wall, eight 
custom-built seats are to be finished in 
turquoise and white to match the smart 
Kroehler sofa-bed of nylon and fabrilite 
fabric. 

Across the hall is the board room 
where the mahogany finish is contrast- 
ed with a knotty cedar panelled wall. 
This room, which will be equipped with 
close to 100 stacking armchairs, finish- 
ed in plastic Fabrolite, will be available 
for board meetings, conferences, as well 
as social events. It lends itself ad- 
mirably to bufifet service when a social 
event is scheduled. A blackboard and 
movie screen is yet to be installed 
opposite the windowed wall. When not 
in use they will be concealed by Flite- 



Deck turquoise drapes. 

A well-appointed kitchen in natu- 
ral mahogany finish is equipped with 
an electric stove as well as ample 
refrigerator and cupboard space. Lead- 
ing off from it is the lunch room, very 
modestly equipped with a chrome 
dining suite. 

Across the hallway from the lunch- 
room is the library, furnished in sub- 
stantial oak pieces. 

A storage vault, stationery and fur- 
nace room, washroom and janitor 
facilities occupy the balance of the 
space on the lower floor. 

With an eye to a source of revenue 
to help complete the payments on the 
building, a third floor, comprising some 
2800 feet, was added. Divided into 
spacious quarters, equipped with wash- 
rooms and janitor space, they will 
make ideal office accommodation for 
some lucky tenants. 

Each floor is individually heated and 
air-conditioned, with access to front 
and back stairs. 

A large parking space will accom- 
modate cars of staff, tenants and 
visitors. 

Bricks, mortar, steel and glass are 
inanimate objects until they have been 
translated into working areas. With 
this thought in mind, and the A.A. 
R.N.'s record of achievement in 
making this building a reality, we 
believe the new Provincial Office of the 
Alberta Association of Registered 
Nurses will be a place where dreams do 
come true. 

Clara Van Dusen 
Executive Director 



The convener of the program committee 
might find it helpful to consider these points 
as she and her committee members plan 
activities for the organization. 

1. Are you bringing more members into 
active participation? The responsibility 
for planning the program should not fall 
on the same old faithfuls every year. 

2. Do your programs help the members in 
their work ? You will want to make certain 
that there is something to appeal to 
nurses in all types of positions and speci- 
alties represented in your section. 

3. Do you make a point of avoiding the 
"same old thing" every year? Too pre- 
dictable a pattern can kill interest. 



4. Do you have specific short-term goals ? 
Some groups may find it worthwhile to 
choose a particular theme for one year's 
emphasis. 

5. Do your members know your calendar of 
forthcoming events? This may help to 
increase the size of your meetings. Plan- 
ning the full year can help your budget 
committee. 

6. How many meetings should you hold ? 
No matter how large or small your com- 
munity, people are going to be busy. 
Schedule only as many events as can be 
handled well. 

— American Jountal of Nursing 



FEBRUARY, 1959 • VOL. 55, No. 2 



105 



Gastrointestinal Intubation 



W. Grobin, M.D. 



GASTRIC INTUBATION has been prac- 
tised for well over 150 years. Dr. 
Physick, of Philadelphia, is known to 
have been the first on this continent to 
pass a tube into the stomach for medi- 
cal purposes. That was in 1812. Siixre 
that time many procedures of intu- 
bation have been developed. Each in 
turn had its adherents for a while. 
Most of them are not in use any more 
since the modern methods of x-ray ex- 
amination have brought much greater 
accuracy to the diagnosis of diseases 
of the gastrointestinal tract. In spite 
of these advances, however, and in 
some cases because of them, some 
procedures of intubation are coming 
back into use more and more. The 
following are still being used almost 
universally : 

1. Gastric analysis — for diagnosis 
only : 

(a) Fractional with CHO meal — 
Rehfuss method 

(b) Insulin test 

(c) Histamine 

(d) Caffeine 

2. Duodenal drainage — mainly for 
diagnostic, but sometimes for treatment 
purposes. 

3. Miller Abbott tube ■ — mainly for 
treatment; also for diagnosis in conjunc- 
tion with x-ray. 

4. Wangensteen tube — treatment pur- 
poses. 

5. Gastric lavage — mainly as a treat- 
ment but has some diagnostic value. 

More elaborate procedures, based 
on the above, are used in research 
laboratories to study the gastroin- 
testinal tract. There are the double 
and triple lumen and balloon tubes 
that enable one to remove gastric juice 
from one area without admixture from 
above. The double balloon tube is now 
used with increasing frequency to 
arrest bleeding from esophageal or 
gastric varices. 

It is the writer's impression that 
some of these procedures, although 



Dr. Grobin. formerly of St. John's, 
Newfoundland, is practising in Toronto. 



ordered routinely by most doctors and 
carried out on the wards of most hospi- 
tals as a matter of course, are usually 
unsatisfactory and the results obtained 
unreliable. This particularly applies to 
gastric analysis. 

The writer may be forgiven if he 
feels rather strongly on this subject. 
Having himself passed many tubes into 
the stomach and the duodeninn, he 
knows how easily it can be accomplish- 
ed if an expert does it. On the other 
hand, the inexperienced can reduce a 
patient to tears and cause an uproar 
because the patient "could not swal- 
low the tul)e." Admittedly, the in- 
stances of complete inability to pass 
the tube are rather rare. The percent- 
age of cases in which excessive gagging 
takes place during the act of swallow- 
ing, and even later throughout the 
procedure, is undoubtedly high. Gag- 
ging causes a reflux of bile into the 
.stomach. At the same time more saliva 
is being swallowed than would ordi- 
narily be permitted to happen. Both of 
these juices diitite the gastric contents 
and alter their composition to such 
an extent that the results of the tests 
are largely rendered valueless. 

The fractional gastric analysis with 
a carbohydrate meal as a stimulant 
is generally considered as the best 
method of examining the total work of 
the stomach. It includes both its motor 
work and its secretions. The motor 
work is gauged by measuring the 
amount of bread left in the samples 
of juice aspirated throughout the test. 
Fast disappearance means overactivity; 
large amounts of bread in the last 
sample — delayed emptying. If record- 
ed on a chart designed for the pur- 
pose, this information can be useful. 
The degree to which the bread has been 
chymified is also of interest. Other 
facts that emerge are the amount of 
fasting juice, its appearance, the pre- 
sence of abnormal constituents, such as 
food from the day before, pus, (swal- 
lowed pus will be mixed with mucus, 
bile-stained pus will point to the duo- 
denum), malignant cells, blood (if only 
present in the samples which are bile- 



106 



THE CANADIAN NURSE 



stained, it points to the duodenum ) . 
Lactic acid indicates gastric retention. 

The degree of free and total acidity 
in the fasting as well as the fractional 
samples can be estimated. Each one of 
these findings has its significance, and 
the total information can be of great 
help especially in cases where the x-ray 
investigation has failed to provide a 
clear diagnosis. In other cases it will 
help to form an idea about the course 
of treatment that should be followed 
and the chance that medical treatment 
will or will not be successful. 

The majority of doctars order gastric 
analysis as part of the routine of a 
gastrointestinal investigatictfi. They 
tend to glance only briefly at the 
acidity curve and perhaps at the pre- 
sence of lactic acid and malignant cells 
if this examination was done. The 
finding of occult blood is usually ignor- 
ed because it is suspected to be due 
to trauma during aspiration of gastric 
juice. This suspicion is unfortunately 
justified. Low acid findings, if they do 
not fit one's expectations in a given 
case, make one suspect that the tube 
had been allowed to pass into the 
duodenum, or had not been passed 
into the stomach at all, but had remain- 
ed in the lower esophagus. The aspirate 
is in reality, saliva. Again, experience 
has taught us that such suspicions are 
justified. In order to obtain correct 
readings of free and total acid, the 
samples should be tested as soon as 
possible after extraction. Some hospi- 
tals have not the facilities for titration. 
All the samples are collected and then 
sent to a central laboratory, arriving 
there perhaps one or two hours later. 
This will undoubtedly alter the actual 
acidity levels. 

These are just a few of the pitfalls 
which seriously diminish the value of 
this otherwise excellent test. 

In the case of the histamine test. 
the situation is somewhat simpler, but 
it also has its pitfalls. Its main use is 
to establish whether the patient has .an 
absolute achlorhydria — that even after 
an injection of a potent preparation 
of histamine, his stomach is unable to 
secrete hydrochloric acid. This helps 
in the diagnosis of pernicious anemia, 
in particular. If the histamine is in- 
active, or if the tube is not in the 
stomach, the results will be useless. 
On the other hand, if the fasting speci- 



men contains free acid, it is unneces- 
sary to proceed with the test. Achlor- 
hydria has been ruled out. 

The insulin test is based on the fact 
that the stomach secretes hydrochloric 
acid if the individual has been given 
enough insulin to lower his blood 
sugar to hypoglycemic levds. This re- 
action takes place if the vagus nerves 
to the stomach are intact. After vagoto- 
my this test has some value in esti- 
mating how thoroughly the surgeons 
have been able to disrupt the vagal 
nerves to the stomach. If, after an 
adequate dose of insulin, the sugar has 
been depressed to, say, 0.50 mg.% and 
the gastric juice samples during the 
following hour fail to show a rise in 
free hydrochloric acid, one can assume 
that vagotomy was satisfactory. 

The caffeine test has been used in 
some places instead of the carbohydrate 
meal. It is claimed that when high 
acidity curves are obtained after stimu- 
lation with caffeine, it indicates 
duodenal ulcer or potential duodenal 
ulcer. 

Duodenal drainage was developed by 
Lyons, of Philadelphia, in the 1920's. 
It was used primarily for diagnosis of 
diseases of the biliary tract. Lyons 
claimed great successes from its use as 
a treatment of early infections of the 
gallbladder. Duodenal drainage enjoyed 
great popularity in the 1930's and 
early 1940's. especially in European 
medical centres. As the x-ray exami- 
nation of the biliary tract became more 
efficient, interest in duodenal drainage 
naturally decreased. Many present-day 
doctors and nurses have never even 
seen it performed. As a method of 
treatment, it has never been accepted 
without challenge, though there are 
still some clinicians who report its use 
in certain conditions, such as the ob- 
structive phase of infectious hepatitis. 
The writer has used this "non-surgical 
drainage of the galltract" in a few such 
cases with undoubted benefit. 

The main value of duodenal drain- 
age is in the diagnosis of diseases 
of the duodenum, biliarv tract and 
pancreas. During recent years it has 
been used mainly in the research labo- 
ratories for the study of pancreatic 
function. The tip of the tube is guided 
into the second part of the duodenum 
under fluoroscopic control. An injec- 



FEBRUARY. 1959 • VOL. 55. No. 2 



107 



tion of Secretin is given, which acts as 
a stimulus to the pancreas. The volume, 
chemical and cytological composition 
of the juice obtained is then studied. 
An injection of magnesium sulphate 
through the tube relaxes the sphincter 
of Oddi and permits bile from the 
gallbladder and from the liver to reach 
the duodenum and thus to be aspirated. 
The bile so obtained can be examined 
for abnormal constituents. It can be 
cultured and its chemical composition 
studied. 

Cholesterol crystals are good evi- 
dence of stones in the biliary tract ; 
blood or pus, especially if bile-stained, 
has great diagnostic significance. Malig- 
nant cells may be found in the duo- 
denal juice. If, after repeated injections 
of magnesium sulphate, no bile can be 
obtained and the same failure to obtain 
bile is verified by a second duodenal 
drainage, obstruction of the common 
duct is almost a certainty. In clinical 
practice this examination becomes par- 
ticularly useful when x-ray exami- 
nation of the biliary ways is un- 
satisfactory or impossible, as, for ex- 
ample, in many cases of severe jaundice. 

Little need be said about the use 
of the Miller-Abbott tube in the treat- 
ment of bowel obstruction. Thanks 
to the cooperation of the radiologists, 
this method has become very success- 
ful and has permitted the surgeons 
to wait until the patient is in good 
shape for operation. By injecting a 
small amount of barium through the 
tube, the site and nature of the ob- 
structing lesion can be determined. 
In cases of paralytic ileus, the Miller- 
Abbott tube enables us to carry on 
with intravenous replacement therapy 
until the bowel has recovered normal 
function once again. 

Both the Wangensteen tube and 
gastric lavage are used mainly for 
treatment. Preoperative and postoper- 
ative management of patients has great- 
ly improved thanks to the judicious 
use of the Wangensteen tube. It is 
of great value in cases of paralytic ileus 
if for some reason a Miller-Abbott 
tube cannot be passed. The rationale 
of its use in this condition is that 
most of the air found in the bowel is 
swallowed air. Acute dilatation of the 
stomach is another very important 
condition in which both the Wangen- 
steen tube and lavage are of great 



value. One must not forget, however, 
that tubercle bacilli and malignant cells 
can be recovered from gastric contents 
by special techniques. 

Finally, the indwelling tube used 
mainly for tube feeding has to be 
mentioned. It, too, finds a place in 
diagnosis. Overnight collection of gas- 
tric juice is being used in many centres 
as a method of study as well as for the 
proper evaluation of the ulcer patient. 
Night secretion is considered to be of 
great importance in the production and 
persistence of peptic ulcer. Continuous 
neutralization by indwelling" tube with 
antacids had its vogue some ten years 
ago and still has its use in the re- 
fractory case of peptic ulcer. 

As mentioned under gastric analy- 
sis, the success of all these procedures 
depends on careful attention to detail. 
Though essentially medical, they have 
to be standardized in the same way as 
surgical procedures. A routine has to 
be followed in each case, and yet there 
must be an experienced person super- 
vising the crucial stages of each pro- 
cedure. He may order a change in rou- 
tine, if necessary, or discontinue the 
procedure altogether if conditions so 
require. Nobody can claim that intu- 
bation is a pleasant procedure. Many 
patients dread the thought of a tube. 
Patients with digestive disorders have, 
for obvious reasons, difficulty in swal- 
lowing tubes. The experienced tech- 
nician can greatly facilitate the pro- 
cess of swallowing. This is especially 
important because not infrequently in- 
tubation has to be repeated. 

After many years observing the un- 
satisfactory results of gastroduodenal 
intubation in general and that of frac- 
tional gastric analysis in particular, 
the writer is of the opinion that intu- 
bation should be considered as a spe- 
cialty and be placed under the direction 
of a nurse or technician with special 
training and interest in this field. This 
person could then in turn train others, 
so that the hospital would be sure to 
have at all times somebody available 
who is well versed in the proper tech- 
nique of gastroduodenal intubation for 
therapeutic as well as diagnostic pur- 
poses. 

I am a man, and nothing that concerns 
a man do I deem a matter of indifference to 
me. — Terence 



108 



THE CANADIAN NURSE 



Dnodenal Ulcer 



Helen Lemieux 



MR. Baker, 65 years old, well 
educated, intelligent, had recently 
retired from an executive position with 
a national firm after a useful, busy life. 
A father, and grandfather, he was 
obviously devoted to his seven children 
and their families. These ties plus an 
avid interest in music and photography 
had helped him adjust to his retire- 
ment from a more active life. He was 
admitted to hospital for treatment of a 
recurrent ulcer. 

Medical Background 

Physicians have for years argued 
about the relationship between worry 
and excitability and the so-called ulcer 
patient. It is believed by many that 
there is a definite tendency towards 
the condition in the person who pos- 
sesses these characteristics. Ulcers oc- 
cur more often in males between the 
ages of 20 and 40 and seem to favor 
the spring and fall seasons. 

Medical History 

A peptic ulcer is an excavation found 
in the mucosal wall of the duodenum, 
the stomach, or the distal esophagus and 
is due to the erosion of a circumscribed 
area of its mucous membrane. The 
etiology is poorly understood, but it 
seems to develop in persons who are 
emotionally tense ; however whether this 
is the cause or effect of the condition 
is uncertain. 

Mr. Baker had been in hospital five 
years previously for treatment of an 
active peptic ulcer. He recovered well 
from it and was discharged after a 
brief stay. A year later he was re- 
admitted for removal of an enlarged 
prostate gland. The operation apparent- 
ly left no ill eflFects. It might also be 
well to mention that he suflFered from 
hypertension and was periodically 
treated for this condition. He had a 



Miss Lemieux wrote this nursing care 
study while she was a junior student at 
St. Mary's Hospital, Montreal. 



coronary thrombosis several years ago, 
but apparently had recovered rather 
well from it, as he was quite active and 
had no handicap. A superficial phle- 
bitis of the left leg was also revealed 
through his history. This left no ill 
effects. For four days prior to this 
admission, Mr. Baker had been passing 
tarry stools. He had also felt extremely 
weak but had no acute pain in the 
abdomen or other regions. On the 
evening of his admission, he had a 
massive hemorrhage from the bowel. 
This prompted him to call his physi- 
cian. 

On admission Mr. Baker's face was 
noticeably pale, he was extremely weak 
but very alert, and he looked worried. 
A blood pressure of 118/78 on ad- 
mission revealed loss of blood. Mr. 
Baker was very apprehensive. Special 
care and patience were necessary to 
put him at ease and ensure proper 
understanding of and cooperation in 
the treatments he would receive. 
This apprehensiveness was partly due 
to the fact that he was suffering from 
a temporary anemic condition due to 
loss of blood. It seemed probable that 
Mr. Baker was suflFering from a bleed- 
ing duodenal ulcer. 

Although he was not in pain at the 
moment, there seemed to be some 
tenderness in the left lower quadrant 
upon palpation. The pain, character- 
istic of this condition, is a dull burning 
one which usually occurs from two to 
four hours after a meal and is usually 
relieved by an alkaline or milk. Other 
symptoms typical of ulcer are exhibit- 
ed, one of which is vomiting. This is 
usually due to pyloric obstruction, 
either muscular spasm of the pylorus, 
or mechanical obstruction. Mr. Baker 
frequently vomited a dark "coflFee- 
grounds" emesis. This was probably 
due to destruction of the mucous mem- 
brane of the stomach with some blood 
and vessel destruction. Hemorrhage 
is sometimes found in the ulcer patient, 
although this is considered a complica- 
tion rather than a symptom. Tarry 
black stools show evidence of hemor- 



FEBRUARY, 1959 • VOL. 55, No. 2 



109 



rhage and frequently fresh blood is also 
found upon defecation. The blood loss 
explained why Mr. Baker's hemoglobin 
was 6.7 gm. per 100 cc. on admission 
instead of a normal 12.0. 

The diagnosis was gastrointestinal 
hemorrhage due to a bleeding duodenal 
ulcer. 

An x-ray revealed that the esopha- 
gus was normal, as was the stomach 
whose curvatures were well-defined 
and whose mucosal pattern was well- 
preserved. The pylorus was patent. 
However the duodenal cap was deform- 
ed by deep indentations on its greater 
curvature, and in the center a large 
barium spot was present. The duodenal 
ring was not enlarged, but evidence 
of a large diverticulum on the medial 
aspect of the second duodenal portion 
was noted. This confirmed the origi- 
nal diagnosis of bleeding duodenal 
ulcer. 

Urinalysis was essentially normal. 

A chest x-ray is usually routine 
in order to detect any serious chest 
deformity or lung disease, in particu- 
lar tuberculosis. It revealed an eleva- 
tion of the right diaphragm, that had 
been noted during a previous examina- 
tion in 1954. However, it further 
revealed a horizontal density immedi- 
ately above the upper limit of the dome 
of the right diaphragm probably due to 
a pleural effusion of recent flcxelop- 
ment. 

Ther.jlpy and Xursing C'aki: 

Mr. Baker's anemia from the hemor- 
rhage was corrected by blood trans- 
fusions. He was kept on complete bed 
rest to prevent excessive bleeding and 
to help heal the ulcer. I'lood pressure 
readings every four hours were used to 
detect possible shock. 

The main medical treatment of a 
bleeding peptic ulcer is diet. Mr. l'>aker 
was treated medically for apj)roximate- 
ly two weeks. Diet therapy consisted 
of giving him no solid food, but 
frequent feedings of milk and cream. 
This protected the ulcer from exposure 
to gastric juice by neutralization. They 
are bland and non-irritating. Feedings 
are given in frequent small amounts so 
that the stomach at no time is over- 
loaded, and sexere peristalsis is pre- 
vente< 1 . 

Medication also plays an important 



role in the treatment of ulcer. 

Atropine is a drug derived from the 
plant Atropa belladonna. It is anti- 
cholinergic — that is, it blocks the 
action of acetylcholine. By blocking 
this chemical, which is normally released 
when the parasympathetic nervous sys- 
tem is stimulated, the vagus nerve is 
depressed. In turn, gastric secretions are 
lessened as well as gastric moti"lity. The 
drug is given gr. 1/150 t.i.d. and at h.s. 

Amphojel is an antacid. It lowers the 
acidity of the gastric content, mainly by 
neutralizing the excessive stomach se- 
cretion of hydrochloric acid. It may be 
given in doses of two drams every hour. 

Premarin 20 mgm., was ©rdered in this 
instance to be given directly into the 
blood stream with the intravenous fluids, 
to help control excessive hemorrhage. It 
is a synthetic drug composed of conjugat- 
ed estrogenic hormones. 

Phenobarbital was also given. It has 
a long-acting sedative and hypnotic 
effect on the body, promoting muscle 
relaxation. It was ordered gr. % t.i.d. 
and at h.s. 

Morphine helped to keep the patient 
sedated. It is a derivative of opium and 
is commonly used as a central nervous 
system depressant. It was given in doses 
of gr. %, immediately following ad- 
mission. 

CMoralol was also given. It is a mem- 
ber of the chlorinated hypnotic group. 
Its action depresses the cerebrum and 
spinal reflexes, and produces slec]). 
Grains 10 was given at h.s. 

Potassium chloride was added to each 
intravenous injection of gluco.se and 
saline solution to ensure electrolyte 
balance. It was given both preoperative- 
]y and postoperatively. 

Vitamins B and C were a necessity 
both before and after operation, because 
Mr. Baker had not been eating. 

Mr. Baker's heart function was not 
adequate. This was noticed by some 
distention in the neck veins due to blood 
backing up into the inferior vena cava 
from the heart. For this reason, he was 
digitalized. A patient is said to he 
"digitalized" when the optimum cardiac 
effects from the drug have been reach- 
ed. Mr. Baker was given 0.5 mg. of 
Digoxin b.i.d. for two days until he was 
digitalized, then a maintenance dose of 
0.25 mg. b.i.d. was ordered. Digoxin is 
a purified substance extracted from the 
leaves of white foxglove. These snb- 



110 



THE CANADIAN NURSE 



stances act on the heart muscle itself 
strengthening its contractions and im- 
proving the output. This, in turn, relieves 
pulmonary edema and poor circulation. 
It is important to take the patient's 
pulse before administering the drug. It 
should be withheld if the pulse is lower 
than 60. 

Seconal I5/2 grains was ordered when 
the patient recpiired a hypnotic after h.s. 
Seconal belongs to the barbiturate family, 
is short acting and produces a restful 
sleep. 

Mr. Baker's intake and output were 
noted to check his electrolyte balance 
and to detect any cardiac deficiency 
resulting in edema. His general health 
had to be improved so that surgery 
could be performed. Blood transfusions 
were continued until his hemoglobin 
was normal. 

He presented some nursing problems 
(luring this period. He was restless. 
;ipprehensive, worried and nauseated. 
The latter was especially distressing 
to him. He felt he would never get 
well unless he could reach a satisfactory 
nutritional state. His nausea seemed to 
last up to about one hour after his 
feedings, and he often vomited half 
digested milk with fresh clots of blood. 
For this reason he was finally left at 
complete rest following his feedings 
and if he vomited, a second feeding 
was attempted after a half hour, usually 
with success. 

Mr. Baker's stool became free of 
visible blood and for three days speci- 
mens for occult blood were collected. 
Kxaniination showed that his stools 
were completely free of blood and it 
was at this point that surgery was 
decided upon. 

It is a hard task to determine which 
ulcer patient will benefit from surgery 
and which one will not. Tt is certainly 
not considered a cure for the condition. 
The old statement of "once an ulcer 
patient, always an ulcer patient" seems 
10 prove true in many cases. Surgery 
is often performed when the patient is 
over 50 years of age and when severe 
hemorrhage has occurred more than 
once. Subsequent hemorrhage might 
become uncontrollable and eventually 
])rovc fatal in older persons since their 
l>hysical state is already on the decline. 
Mr. Baker seemed verv happy about 
the surgeon's decision and confided 
that he felt something was at last going 



to be done about his condition. 

Specific orders were written for fur- 
ther tests. An electrocardiogram, re- 
quested because of the patient's known 
heart condition, revealed an increasing 
left ventricular ischemia that would 
certainly be important to the surgeon 
and anesthetist during and immediately 
following the operation. 

Intravenous therapy, consisting of 
glucose and water and glucose and 
saline was started about three days be- 
fore the operation in order to keep up 
Mr. Baker's electrolyte balance, to pre- 
vent dehydration and build up his 
general health. Several blood trans- 
fusions were given also. Intake and out- 
put were recorded throughout this 
period. 

Spiritual and psychological prepara- 
tion is very important. It was explain- 
ed to Mr. Baker that although part of 
his stomach would be excised, he 
would still be able to eat. although 
moderately at first. The remaining 
portion of his stomach would enlarge 
somewhat and his nutritional needs 
would be met very easHy. It was also 
important to tell the patient that he 
might feel uncomfortable after the oper- 
ation and that a tube would be inserted 
for a while. A visit from the clergyman 
ma\- also help to put the patient at ease. 

Thk Opi ration 

A major shave preparation was done 
on the preceding day. It consisted of 
shaving the patient from the nipple 
line down to six inches on each le^, and 
on either side from bedline to bedline. 
A soap suds enema was given in order 
to empty the colon before surgery. 

Sedation, consisting of Seconal gr. 
1^/2 was given at bedtime to ensure 
as restful a sleep as possible. 

In the morning a Levine tube was 
inserted. This tube, which was passed 
through the nasopharynx down through 
the esophagus into the stomach, drains 
off the gastric juices and prevents 
postoperative nausea, vomiting and 
gastric distention. 

A second skin preparation was done 
in the morning. This consisted of paint- 
ing the shaven area with ether, then 
alcohol and finally iodine. The pre- 
operative medication consisted of Deme- 
rol 100 mgm, and atropine, gr. 1/150. 
Mr. Baker's blood pressure was 170/ 



FEBRUARY. 1959 • VOL. 55. Xo. 2 



111 



110 and temperature, pulse and respi- 
rations normal prior to operation. 

The abdomen was entered through 
a right paramedian incision and a 
partial gastrectomy performed. This 
consisted of removing the ulcerated 
area in the duodenum and % to ^ of 
the stomach. An end to end anas- 
tomosis was made between the end of 
the stomach and the jejunum. A ciga- 
rette drain was inserted into the duo- 
denal stump to drain any discharge 
to the exterior and to prevent leak- 
age through the duodenal suture into 
the peritoneal cavity. 

Postoperative Nursing Care 

Mr. Baker was brought down from 
the operating room at 2:00 p.m. and 
placed in a quiet ward on surgery 
A nurse remained with him for the 
next hour. He was pale, conscious 
and drowsy. Nasal oxygen was started 
at 2:15 p.m. and continued for six 
hours. At 2:30 p.m. he complained 
of pain in the operative area and deme- 
rol was given "stat." Demerol had 
been ordered q.4 h. p.r.n. for 48 
hours to relieve pain. Meperidine HCl 
(Demerol), is one of the synthetic 
substitutes for morphine. It is not a 
potent drug but has a distinct ca- 
pacity to cause addiction. Its analgesic 
effect in man is slightly stronger than 
codeine and lasts for 2 to 6 hours. 
It is most effective in relieving post- 
operative pain. 

Blood pressure and pulse readings 
were ordered q.l5 m. for two hours 
then every half hour until stable. It 
was 140/110 on return from the oper- 
ating room and remained fairly stable 
throughout the day, rising to 160/120 
in the late evening. A small area of 
bright red blood on the outer dress- 
ings was noticed at 3:00 p.m. At 3:30 
P.M. Mr. Baker was visited by the 
anesthetist and appeared to be re- 
sponding satisfactorily although very 
drowsily. 

An intravenous of 5% glucose and 
water that had been started in the 
O.R. was checked and appeared to be 
running well. The Wangensteen suc- 
tion was draining thick, dark reddish 
fluid. At 4:30 p.m. the patient was 
again visited by the anesthetist. He was 
perspiring freely and his bed linen 
was changed frequently to keep him 



comfortable. The Levine tube was ir- 
rigated frequently all day to ensure 
proper drainage. A sponge bath was 
given to lower Mr. Baker's temper- 
ature which was elevated to 101°. 
Back care was given to prevent the 
development of pressure areas. Chang- 
ing his position every two hours was 
also helpful. 

Deep breathing exercises are very 
important in the prevention of hypo- 
static pneumonia and Mr. Baker was 
encouraged to do them. He was also 
encouraged to cough frequently while 
his suture line was held by the nurse. 
At 8:00 p.m. the nasal oxygen was dis- 
continued since Mr. Baker's breathing 
was greatly improved. Mouth care was 
given q.3 h. throughout the day. At 
10 :30 P.M. Mr. Baker felt very distend- 
ed and voided 480 cc. 

Alevaire inhalations were given 
twice daily for four days to ensure 
a clear passageway into the lungs and 
prevent accumulation of mucus that 
might lead to pneumonia. 

Intravenous therapy postoperatively 
prevented dehydration. Glucose and 
water 1000 cc. was alternated with 
1000 cc. of glucose and saline. The 
intravenous therapy was continued for 
three days. Mr. Baker received 1000 
cc. the first day, 2500 cc. the second 
day, and 3000 cc. on the third and 
fourth days. Wydase, an enzyme, was 
added to help absorption. 

After the first 48 hours, Demerol 
was replaced by aspirin phenacetin 
compound with codeine to prevent ad- 
diction or even a psychic dependence 
on the drug. A preparation of peni- 
cillin and streptomycin (Fortimycin) 
was given twice daily for five days 
prophylactically. Iron, in the form of 
ferrous gluconate was given t.i.d. after 
meals. It was used to combat the 
anemia due to hemorrhage. 

Nothing was given by mouth im- 
mediately postoperatively, and only sips 
of water on the second day. Mr. Baker 
followed the special gastrectomy diet. 
On the third day, he was given one 
ounce of milk alternating with one 
ounce of water every hour. The fourth 
day junket, ice cream, jello, milk and 
water were added. The clysis was de- 
creased to 1000 cc. On the fifth day, no 
intravenous was given. Fluids were 
taken ad lib., with additional pureed 
food and soft eggs. Mr. Baker tolerat- 



112 



THE CANADIAN NURSE 



ed all of this food very well. 

His diet was kept at this level until 
the twelfth postoperative day when a 
bland No. 2 diet was substituted. His 
meals, apart from what he had been 
taking, consisted of cottage cheese, 
mashed potatoes, minced meat, white 
chicken, white fish and melba toast. 
This was continued throughout his 
stay, and was changed to a bland No. 
3 diet when he was discharged. 

On the fourth postoperative day, Mr. 
Baker's Levine tube was clamped. He 
was carefully watched all that day for 
nausea and vomiting. By evening, he 
had shown no signs of distress, and 
the tube was taken out completely. 
His drain was shortened then removed 
on the following day. 

The fifth day after his operation 
the patient was allowed up in a chair 
for 15 minutes. No ill effects were 
noted and each day thereafter, Mr. 
Baker although still quite weak and 
not too sure of himself, spent some 
time out of bed. 

On the 12th day, most of the small 
black silk sutures were removed. The 
incision appeared clean, but at the site 
of the third stay suture, a reddened 
area was noted and a slight purulent 
discharge seemed to be seeping out. 
Magnesium sulphate with glycerine 
compresses were applied to the inflam- 
ed area, in an attempt to halt the pro- 
cess. This was not effectual. On the 
14th day Mr. Baker had a fainting spell 
while in the chair and was immediately 
put on complete bed rest with blood 
pressure readings every half hour for 
two hours. The following day, the 
remaining stay sutures were removed. 
The discharge was still purulent and 
copious in amount. A culture and 
sensitivity test were ordered. The re- 
sults showed a heavy growth of 
Staphylococcus pyogenes and measures 
were immediately taken to control this 



infection and prevent its spread. Mr. 
Baker seemed perturbed about the 
whole thing. His mind was set at ease 
by an explanation and the assurance 
that treatment would be successful. 

A small incision was made and one 
inch packing inserted. The purulent 
discharge became greenish and con- 
tinued in large amounts. Hot com- 
presses were applied q.3 h. and a hot 
water bottle continuously. A few days 
later, when the discharge still con- 
tinued, irrigations with saline were 
ordered and carried out three times a 
day with very good results. 

Health Teaching 

Essentially Mr. Baker has taken 
good care of his health. His person- 
al hygiene was good. It was important 
to try to help him to relax and to dis- 
cuss his difficulties. 

Mr. Baker was anxious to cooperate 
with the doctor and nurse. He sincere- 
ly believed that they had done an es- 
sentially curative treatment by remov- 
ing the afflicted organ. He was dis- 
charged on a bland No. 3 diet. This 
consisted of a nearly normal diet based 
on milk. It was explained to him that 
he must take approximately six glasses 
of milk per day, eat cottage cheese 
often, and avoid spices, broth, roughage 
and bulk. His wife was told that he 
should have simple cooking, no fried 
foods, tender meats often and two eggs 
daily. She was anxious to comply 
with this as she had seen a definite 
improvement in her husband and wish- 
ed to help in whatever way she could. 

Mr. Baker was given one month's 
supply of digoxin 0.25 mgm., and both 
he and his wife were instructed that 
he must take two doses daily. Finally, 
he was advised to revisit his doctor 
frequently at first and to have periodic 
medical check-ups later. 



The apparent self-liquefaction of clotted 
blood and auto-digestion of necrotic tissue 
are age-old clinical observations . . . Recent 
studies indicate that clotted blood is di- 
gested by the proteolytic enzymes present in 
the blood and that necrotic tissue is digested 
by enzymes produced by bacteria, leukocytes 
and body tissues. 

When the proteolytic enzymes are applied 



locally to an infected wound or abscess, they 
digest the complex proteins and pus to de- 
crease the viscosity of the material. The 
degree of phagocytosis is increased and pus 
can be removed from the wound more easily. 
The changes produced by the enzymes thus 
initiate a series of biochemical changes lead- 
ing to healing. 
— American Journal of Nursing 



FEBRUARY, 1959 • VOL. 55, No. 2 



113 



Peptic lloer 



Carole Eldridge 



The Condition 

I PKi^Tic ULCER is an excavation in 
/I the mucosal wall of the stomach, 
the distal esophagus or the duodenum 
that may extend to the muscle layer, 
or even to the peritoneum. Most ulcers, 
whether gastric or duodenal, are found 
near the pyloric sphincter of the 
stonvach, and usually appear singly, 
although more than one may be present 
at a time. 

Peptic ulcers belong lo a group of 
psychosomatic conditions. Their excit- 
ing cause is unknown, but is probably 
due to the digestive action of gastric 
juice on a part of the stomach whose 
nutrition has been impaired by a local 
circulatory disturbance. Contributing 
factors include poor eating habits, ex- 
cessive smoking, emotional tension, 
worry, and other mental stress. 
Worriers, excitable types, and persons 
who are emotionally t-ense l)ut have a 
calm exterior, are all prone to digestive 
ulcers. Statistical studies have shown 
that certain occupations which involve 
a great deal of mental stress and 
tension predispose to the development 
of peptic ulcers, and "there is much 
to suggest that the increase in duodenal 
ulcers may be due to the increase in the 
stresses and strains of modern life." 

An ulcer may remain latent for an 
indefinite period and later be an- 
nounced by hemorrhage or perforation, 
but generally symptoms of dyspepsia, 
epigastric pain and tenderness, nausea. 
\omiting and hyperchlorhydria, occur. 

Complications that may result from 
a peptic ulcer are : perforation and 
peritonitis, hemorrhage, edema or scar 
formation that may obstruct the pyloric 
sphincter. 

The prognosis of a patient with a 
peptic ulcer is guardedly favorable. 
Hemorrhage or perforation may occur 
without warning, and relapses with the 
formation of new ulcers are not un- 
common. To prevent recurrence the 



Miss Elridge will graduate this year 
from Royal Columbian Hospital, New 
Westminster. B.C. 



patient must be taught to avoid stress 
situations, use good eating habits, follow 
his prescribed diet, avoid the use of 
alcohol and tobacco, get iKlequate rest 
and exercise, practise good hygiene. A 
medical examination at least once a 
year, and early reporting of symptoms 
if they return are essentials that must 
not be forgotten if this condition is to 
be controlled. 

The Patient 

Mr. Carter, the youngest of 10 children, 
was born in Birmingham, England in 
1893. Most of his formal education was 
gained there while he went to public 
school, served an apprenticeship, and 
later attended technical school to study 
mechanical engineering. 

In 1914 he came to Canada where he 
spent the next eight years living in the 
Northwest Territories while serving as 
an R.C.M.P. officer, and later as an 
employee of the Hudson's Bay Co. Al- 
though Mr. Carter has been in all the 
Canadian provinces, British Columbia 
has remained his favorite. He has lived 
there for the past 29 years. For this 
length of time he has been employed as 
a machine shop instructor in the pro- 
vincial penitentiary. 

Recreational activities include reading 
and short story writing. He derives 
much enjoyment out of his affiliation 
with a men's club. Mr. Carter has led 
a very interesting life which contained 
its share of tragedy, as well as joy. His 
first wife, whom he married before leav- 
ing England, was killed in a railroad 
accident and his second wife died in a 
fire. Later he remarried, and now has 
a son, daughter, and six grandchildren 
of whom he is very proud. 

Mr. Carter is a large man who stands 
five feet eleven inches tall, and weighs 
230 pounds. He seems to have an above 
average intelligence. Outwardly, he is 
very calm and complacent, always cheer- 
ful, willing and cooperative. He mixes 
well with the other patients, and ad- 
justs himself easily to the ward and 
hospital life. His relationships with other 
patients give him much pleasure. It 



114 



THE CANADIAN NURSE 



was a real joy to care for liini. 
Past History 

Except for a case of recurrent lumbago 
Mr. Carter had been in excellent health 
until 1953 when he was admitted to the 
hospital in severe shock with a diagnosis 
of gastric hemorrhage, and a history of 
hematemcsis and melena. After extensive 
examinations he was discovered to be 
suffering from a duodenal ulcer. Follow- 
ing treatment that included blood trans- 
fusions, other intravenous therapy, drug 
therapy, and diet regulation Mr. Carter 
made a satisfactory recovery. 

He was released from hospital at the 
end of three weeks for further conva- 
lescence at hcmie. On the advice of his 
doctor, he refrained from the use of 
alcohol and tobacco. He began to realize 
that emotional disturbances caused him 
distress, and he tried to avoid them 
whenever possible. For a period of time 
Mr. Carter adhered to his diet and its 
restrictions, then, due either to lack of 
understanding of the importance of diet 
in ulcer healing, inadequate teaching or 
sheer neglect, he became very lax about 
it, and still later made no attempt at 
diet control. 

In early 1955 Mr. Carter spent several 
weeks in bed at home while being treat- 
ed for angina pectoris and persistent 
hypertension. His usual blood pressure 
was 200/110. At this time attempts were 
made to reduce his weight, but they fail- 
ed. About six months before his second 
admission to hospital Mr. Carter began 
to experience gastric distress and a few 
months later, because of its persistence. 
he again visited his doctor. Followiiip 
a barium meal, stomach and duodenal 
x-rays were taken, and revealed that the 
original duodenal ulcer was still present 
and unhealed. A gastric ulcer had appear- 
ed on the lesser curvature of the stomach 
near the pyloric sphincter. He was again 
placed on medical treatment in an at- 
tempt to control his symptoms, and 
appeared to do fairly well. 

PkKSF.NT lll.NK.SS 

A couple of years later. Mr. Cart' r 
was admitted to the emergency ward in 
acute shock following a severe hemate- 
mesis. He was very pale and diaphoretic. 
B.P. 170/100, pulse rapid and thready. 
He complained of epigastric tenderness. 



Physical examination revealed that eyes, 
ears, nose, throat and glands were 
normal. Heart sounds and respirations 
were normal, and chest sounds were 
clear. Questioning at this time revealed 
the presence of melena for about two 
weeks, but apparently the patient did not 
realize the significance. 

For six to eight weeks previoii> to 
this admission, Mr. Carter had been ex- 
periencing dull, aching epigastric pain 
approximately two hours after supper. 
It usually lasted two to three hours, 
and some relief was gained by the use 
of aspirin and a hot water bottle applied 
to the upper abdomen. Later it was found 
that bismuth preparations and milk of 
magnesia would bring about some relief. 
There seems to have been little or no 
attempt on the part of the patient to pre- 
vent and control pain by diet. Dyspep- 
sia, found commonly in ulcer patients, 
was not one of Mr. Carter's symj)- 
toms. He could and did eat anything. He 
found that when he got excited, worried, 
or "mad," epigastric discomfort would 
result. This is a typical ulcer symptom. 

Vomiting, the second classic symp- 
tom of a peptic ulcer, was absent in 
Mr. Carter's history until 30 minutes 
previous to this admission. 

Hemorrhage, as manifested by heina- 
temesis and melena was present in Mr. 
Carter's case, as it is in about 25% of 
all ulcer patients. For about two weeks 
prior to admission he had been passing 
black stools, and on the night of ad- 
mission was nauseated, with a "coffee- 
grounds" emesis that revealed the pre- 
sence of blood in the stomach for some 
time. Following this there was an emesis 
of bright red blood which indicated the 
presence of a frank hemorrhage in the 
upper gastrointestinal tract. After this 
unusual occurrence Mr. Carter's family 
rnslied him to the hospital. 



Lakor.atorv Reports 



nortnal 

45% 



H (luatocrit 

1st day 40.5% 

2nd day 45 % 

3rd (lay 43.S% 

The first hematocrit estimation wa.s 
low because tlie blood had been thinned 
by body fltiids. Following transfusion 
with 2000 cc. whole blood it returned 
to normal. After the transfusions ceas- 
ed more body fluids entered the cir- 
cidation and thinned the blood slightlv 



FEBRUARY. 1959 • VOL 5.^^ No. 2 



115. 



so the number of red cells in each cc. 
of circulating blood was slightly below 
normal. 

Hemoglobin normal 

1st day A.M. 14.6 Gm/100 cc. — 99% 
14-16 Gm/100 cc. 
P.M. 13.5 Gm/100 cc. — 91% 
2nd day 14.4 Gm/100 cc. — 98% 

3rd day 14.6 Gm/100 cc. — 99% 

8th day 12.8 Gm/100 cc. — 86% 

Although on admission it was esti- 
mated that Mr. Carter's blood volume 
was 50 per cent below normal his 
hemoglobin was high. This can be 
attributed to the fact that body fluids 
had not yet had time to pass into the 
blood stream and dilute the blood to 
its normal volume of circulation. The 
giving of 2000 cc. of whole blood intra- 
venously during his first 24 hours in 
hospital replaced a large number of 
the red cells lost in the hemorrhage, 
and helped keep the hemoglobin esti- 
mation high. After 8 days in hospital 
his hemoglobin dropped to 86 per cent. 
One might assume this was caused by 
the fact that the transfusions had ceased 
so no more blood cells were being 
added, and body fluids had ample 
chance to dilute the blood to its normal 
volume. Therefore the blood was thinner 
than normal and the cell volume per 
cc. was lower. 
Non Protein Nitrogen normal 

1st Day 43 mg/100 cc. 23-45 mg/100 cc. 
3rd Day 2>6 mg/100 cc. 
The N.P.N, estimation is lower on 
the 3rd day because the body cells are 
utilizing the ingested proteins more 
completely ; therefore there is a smaller 
volume of waste to be excreted. 
Urinalysis 

Urinalyses were carried out daily and 
the resuhs showed an occasional epithe- 
lial and white blood cell, but this can 
be considered normal. 

sugar -|- 2 normal — neg. 

acetone strong -|- normal — neg. 

The + 2 sugar may be explained 
by the fact that in gastric ulcer pa- 
tients the glucose tolerance curve is 
frequently abnormal. There is some 
disagreement concerning the possible 
pathogenic significance of this fact. 

The presence of acetone in the urine 
denotes an improper fat metabolism. 

Treatments and Medications 

Treatment of the peptic ulcer is 



essentially medical. Surgery, if indicat- 
ed is usually undertaken for the com- 
plications and not for the lesion itself. 

Aims : to avoid complications, to 
create best possible conditions for heal- 
ing, to prevent recurrence. 

Immediately following Mr. Carter's 
admission to hospital a consultation 
was held. The following orders were 
written and carried out: 

Complete bed rest 

Hemoglobin estimation 

Typing and cross matching for blood for 

immediate transfusion 

Blood pressure and pulse q.l h. and 

report changes 

Record intake and output 

First week ulcer regime 

Morphine gr. J4 stat, and gr. 1/6 q.6 h. 

Probanthine 50 mg. q.i.d. 

Daily urinalysis including microscopic 

examination 

Sodium luminal gr. ii h.s. 

Physical and mental rest for Mr. 
Carter was striven for at all times. 
An attempt was made to alleviate ap- 
prehension and fear because the gastro- 
intestinal tract is so sensitive to emo- 
tional stress. By encouraging him to 
voice his fears, by paying attention to 
any worries he expressed, and by ex- 
planations of all treatments and proce- 
dures, we felt that a major step was 
taken towards our aim of mental rest. 

Because of hourly pulse and blood 
pressure readings for the first few 
days physical rest was a real problem, 
but by the wise use of sedation to 
keep the patient drowsy we gained our 
objective. On all occasions he was 
disturbed as little as possible, and he 
did manage to sleep between intrusions. 
On his third hospital day Mr. Carter 
was allowed up in a chair. He tolerated 
this very well, and his activity was 
gradually increased. 

The relief of pain is of extreme 
importance in ulcer patients because 
pain leads to mental distress which 
in turn leads to more pain. Pain also 
increases gastric contractions and this 
can promote the possibility of hemor- 
rhage. Upon his arrival in the ward 
Mr. Carter received morphine gr. ^4 
and at the end of each six hour period 
following this for eight days he receiv- 
ed morphine gr. 1/6. This kept him 
completely pain-free. After his eighth 
day the morphine was ordered to be 
given only when necessary and the pa- 



ne 



THE CANADIAN NURSE 



tient was watched carefully for signs 
of pain. None appeared, and the mor- 
phine was unnecessary thereafter. 
• Probanthine 50 mg. was given to 
Mr. Carter four times daily to de- 
crease gastric motility and secretions 
thereby eliminating a source of irrita- 
tion and pain. By careful observation 
it was decided that this drug was 
achieving its effect. After three days 
the doctor felt that it was no longer 
necessary. In connection with the use 
of Probanthine, it is well to remember 
that constipation and urinary retention 
are two of its untoward effects. On 
one occasion it was necessary to cathe- 
terize Mr. Carter. One half ounce of 
milk of magnesia given twice daily 
helped avoid constipation. 

Antacid therapy in the form of 
amphojel played a major role by pro- 
tecting the irritated gastric mucosa 
from acid secretions. It helped to 
eliminate the cause of increased pain, 
hemorrhage, and mucosal damage, and 
to provide a better environment for 
tissue repair. The dosage started at one 
ounce hourly day and night, and was 
gradually decreased to one half ounce 
four times daily. 

The doctor chose phenobarbital as 
the agent to be used to keep Mr. 
Carter as relaxed as possible. Sodium 
phenobarbital gr. ii hypodermically 
kept him fairly drowsy during his 
first night in hospital. During the 
following day phenobarbital gr. 34 
q. 1 h. was given until the patient 
became soporific. The order was then 
changed to gr. ^ q.i.d. This kept 
the patient relaxed, and fairly drowsy 
at times, but did not allow him to 
become stuporous. 

Diet 

Diet is very important in ulcer 
treatment. It is essential that the pa- 
tient understand the reasons for his 
diet so that his cooperation may be 
gained and he will realize the necessity 
for dietary restrictions following his 
discharge. 

Dietary aims: Adequate nutrition to 

keep something in the stomach at all 

times to neutralize the acid ; 

avoid stimulation and irritation of the 

mucosa ; 

high caloric value ; 

easily digested foods. 



high protein intake to promote repair; 
Sippy milk (9% cream) is ideal for 
this purpose. 

Mr. Carter received his first feed- 
ings (sippy milk three ounces, and 
amphojel one ounce) by gavage. Care 
was taken that the feeding was warm, 
and that no air was introduced into 
the tube. Gravity drainage was used 
to introduce the feeding into the stom- 
ach so that no undue pressure would 
be exerted against the gastric walls. 
A small quantity of warm water was 
introduced after each feeding to clear 
the tube. 

Early in his second hospital day 
Mr. Carter complained of epigastric 
distress, was nauseated with 24 ounces 
of yellow emesis, and expelled his 
Levine tube. It was decided that the 
tube was no longer necessary. The 
patient tolerated his diet very well 
without its use. The gradual progres- 
sion to second and third week ulcer 
diet was tolerated extremely well. It 
had a definite psychological value in 
that the patient recognized dietary 
progression as a sign of an improve- 
ment in his condition. 

Vitamin supplements in the form 
of B-plexi2, ascorbic acid, and hali- 
but liver oil were added to the diet 
after the first week to help achieve 
adequate nutrition. 

Blood Transfusions 

Because of the severity of the hemor- 
rhage Mr. Carter had suffered before 
his admission, it was necessary to 
replace 2000 cc. of blood through the 
use of transfusions. Laboratory ex- 
amination disclosed his blood type 
as O negative, but because of an in- 
adequate supply in the blood bank, 
and the fact that this was a male pa- 
tient, it was acceptable to use O posi- 
tive blood that had been carefully Cross- 
matched against his. 

It was necessary to watch constantly 
for signs of an untoward reaction such 
as flushing of the face, headache, chills, 
muscle pain, or dyspnea which would 
show an incompatibility between donor 
blood and that of the recipient. Early 
in the administration of his second 
1000 cc. of blood Mr. Carter's face be- 
came very flushed. The transfusion was 
slowed and the untoward symptom 
vanished. This was the only reaction 



FEBRUARY, 1959 • VOL. 55, No. 2 



117 



that arose during the transfusions. If 
a reaction had been suspected at any 
time the transfusion would have been 
clamped, and the proper authorities 
notified. 

On admission Air. Carter had a 
blood pressure of 170/100, but about 
three hours later it had dropped to 
80/60 — an extremely low level for 
a hypertensive patient. Next morning 
his doctor remarked : 

At the termination of 1000 cc. blood 
the patient's general condition is only 
satisfactory — B.P. 138/80. He needs 
more blood but I think it can be assumed 
that he has stopped bleeding. Any sign 
today indicating further hemorrhage 
would be an absolute indication for 
operation as an emergency. 
After the absorption of the second 
1000 cc. of blood Mr. Carter's blood 
pressure reached 150/92. For the fol- 
lowing two weeks it ranged between 
125/74 — 150/92. No signs indicating 
further hemorrhage were noted. 

Nursing Care 

Tl>e nursing care given Mr. Carter 
always aimed at establishing his con- 
fidence in his nurses and doctors, the 
hospital and its stafif in general. Rou- 
tine nursing measures were used to 
keep the patient and his linen clean, 
and his bed comfortable. Special at- 
tention to oral hygiene was very im- 
portant. Doc-tor's orders were carried 
out promptly, and the patient's re- 
sponse to treatment was charted ac- 
curately. 

Mr. Carter was observed at all times 
for restlessness. This is a significant 
sign that may mean the presence of 
hemorrhage, urinary retention, or ner- 
vous tension, all of which must l)e 
avoided. Any special change in con- 
dition must be reported and recorded. 
The taking of blood pressure and pulse, 
and the recording of the rate and 
quality each hour for his first three 
days in hospital, and twice daily there- 
after helped the doctor to gain an 
accurate estimation of Mr. Carter's 
circulatory picture. 

In res|ject to diet it was extremelv 
important that feedings were gi\en on 
time, that the proper amount was given, 
that the milk was always fresh, and 
at no time were dirty glasses allowed 
to collect at the bedside. An accurate 



record of intake and output was kept, 
and the patient's tolerance to diet in- 
crease was noted. Because hourly feed- 
ings and constant repetition of the 
same food was already a strain on the 
patient, it was essential that feedings 
should be delivered with the right at- 
titude, that the patient was not allowed 
to feel that the feedings were a burden 
to the nurse, and something to be dis- 
posed of as quickly as possible. Record- 
ing the amount and type of emesis 
was a nursing responsibility also. 

As the patient's condition improved 
he was encouraged to gradually de- 
crease the time spent in bed, and to 
increase his exercise. Care was taken 
that he did not become tired. 

It is easier on the patient, and on 
his relatives, if they are informed 
before entering his room of any special 
treatments that are in progress. A 
simple explanation is all that is neces- 
sary, and it will save the relatives a 
great deal of mental distress. The pa- 
tient will also feel better because his 
friends will not be exchanging worried 
glances. 

Mr. Carter had been informed dur- 
ing his early hospitalization that an 
operation was essential and a date 
was decided. It then became a nursing 
responsibihty to give the patient an 
adequate physical and mental jjrepa- 
ration for this procedure to pre- 
vent him from going to the operating 
room in an apprehensive and anxious 
state. Explanations of procedures that 
could be expected both pre- avd post- 
operatively were given. The patient 
was encouraged to exercise his arms 
and legs, and to practise deep breathing 
in preparation for this postoperative 
period. He was crossmatched for six 
pints of blood in preparation for sur- 
gery. Mr. Carter was tran^sferred to 
a surgical floor to allow for adequate 
orientation before his operation. 

He w.'us very cheerful when he left 
our ward, but he was sorry to leave 
his new friends. He had a good atti- 
tude towards his coming surgery, and 
looked forward with anticipation to a 
rapid postoperative recovery, and the 
day that he would leave the hospital. 

Thk Opi.r.ation 

Under sodium pentothal and niliou> 
oxide, and using the drug Flaxedi-I to 



118 



THE CANADIAN NURSF: 



gain the desired muscular relaxation, a 
two-thirds subtotal gastric resection was 
performed on Mr. Carter. The surgeons' 
task was made more difficult because the 
patient's obesity had caused the trans- 
verse colon to become very enlarged, 
and the mesentery very short. Before 
the incision was closed a 1-inch Penrose 
drain was placed near the duodenal 
stump and brought out at the lateral 
end of the incision. A Levine tube was 
pas-sed via the patient's nares to the 
stomach. During the operation the anes- 
thetist kept a constant check on Mr. 
Carter's blood pressure, and administered 
2000 cc. of blood, and 500 cc. of I.\'. 
solution to help replace the blood loss, 
to help maintain the blood pressure, and 
to lessen the chances of shock. 

POSTO PI:R A'l- 1 \E C A R 1 . 

On return to the ward a retention 
catheter was inserted and left in place 
for the first three postoperative days 
to avoid th€ complication of urinary 
retention. The doctor also ordered 
Chloromycetin to be given daily as a 
precautionary measure, and Bionet 
lozenges every two hours to help re- 
lieve the throat irritation caused by the 
Levine tube. The irritation of the throat 
mucosa by the tube caused an increase 
in mucous production. This resulted in 
much discomfort. 

Blood chemistry readings were taken 
frequently, and very extensive intra- 
venous therain' was instituted to main- 
tain the patient's electrolyte balance. 
The doctors ordered demerol to relieve 
pain, and Largactil to help the patient 
rest. 

.\fter four days, because of a con- 
stant seej^age of bile onto the dressings 
a catheter was inserted into the wound 
and a Stedman motor attached to the 
drain. The doctor ordered aqueous 
penicillin as the agent to ward off in- 
fection. All throughout the postopera- 
tive period the drain was a constant 
source of trouble. Bile seepage still ap- 
peared around it and caused a large 
red excoriated area on the patient'."^ 
skin. Barriere cream and \aseline 
dressings were ordered for the area 
but the patient seemed to get little 
relief. The orders were changed to 
cod liver oil dressings, zinc oxide, 
and later to aluminum paste before 
the desired effect was achieved. Lca\- 



ing the abdomen exposed and applying 
the infrared lamp three times daily 
gave the patient a great deal of com- 
fort. The area gradually became less 
troublesome. Eleven days postopera- 
tively the skin sutures were removed, 
and about three weeks later the drain 
was taken out and the patient was 
taught to do his own dressings. 

The Levine tube was left open im- 
mediately postoperatively, and the 
length of time it was clamped off was 
gradually increased. At first the clamp- 
ing caused the patient much discom- 
fort, but this decreased little by little. 
Mr. Carter was restricted to sips of 
water for over two weeks until the 
Levine tube was removed. He gradu- 
ated to clear fluids, but the tube had 
to be reinserted next day because of 
persistent nausea and bile emesis. 
When the tube was again removed the 
patient was placed on a postoperative 
gastric regime of equal parts milk and 
water which he tolerated very poorly. 
This diet was changed when it was 
found that chicken broth was more 
agreeable to the patient, and better 
tolerated. Because nausea was still 
troublesome at times the dietary in- 
crease to pureed and bland foods had 
to be made very slowly. Vitamins 
A and B, ascorbic acid, and B-plex 
were given throughout the postopera- 
tive period to supplement the intra- 
\enous therapy and the diet. A care- 
ful record of intake and output was 
kept at all times. 

Mr. Carter was encouraged to move 
about in bed and dangle his legs early 
in his recovery period, but he seemed 
reluctant to do so. Later when the tubes 
were clamped, he was helped up into 
a chair each day. Getting him up was 
a problem for his nurses because of his 
size and weakened condition. Also, his 
])eriods out of bed had to be fitted 
in between the intravenous fluids that 
were running almost constantly. As 
he became stronger, the doctor encour- 
aged him to get up for at least one 
half hour before and after each meal, 
and to spend as much time as possible 
out of bed. Mr. Carter lost a great deal 
of weight. He was ^•ery depressed at 
limes because of his slow recovery, and 
the complications that had arisen. But as 
his strength returned he began to look- 
forward to his visits with other am- 
bulatory patients and was very cheer- 



FEBRUARY. 1959 • VOL. 55. No. 2 



119 



ful at the thought of being home for 
Christmas. The speciaHst called in to 
perform the operation stated that the 
complications encountered during Mr. 
Carter's recovery period will in no 
way alter the fact that only 3-5 per 
cent of ulcer cases of this type are re- 
current. Mr. Carter's prognosis then is 
very good. 

Patient Teaching 

The morning bath provided an ex- 
cellent opportunity for patient teaching. 
During discussions about peptic ulcers 
in general, and his case in particular 



the importance of proper diet, rest, 
exercise, and hygiene was stressed. He 
is not in the habit of using alcohol and 
tobacco, and was cautioned against 
their use in the future. The avoidance 
of stress situations will play a major 
role in the prevention of ulcer recur- 
rence. A regular medical examination, 
and prompt reporting of any of his 
previous symptoms if they return were 
advised. Mr. Carter was cautioned 
against self-medication and the use of 
patent medicines. Only medications 
ordered by the doctor should be used, 
and care should be taken that the doc- 
tor's orders are followed carefully. 



Pyloric Stenosis 



Adeline Pavan 



WELL, IT didn't take ME tOO loUg tO 
make a second trip to hospital! I 
am just one month old and hardly yet 
accustomed to my pretty blue bassinet ! 
It seems ever since I can remember, 
although I enjoyed my bottle very 
much and could hardly wait for it, 
I just could not seem to retain my 
feedings. Our doctor advised Mother 
to take me to the hospital. She seemed 
quite surprised when the nurse placed 
me on the scales (without a stitch 
of clothes on!) and informed her that 
I weighed 7 lb. 8 oz. — quite a dif- 
ference from my birth weight of 8 lb. 
6 oz. Mother explained that since she 
never did get around to buying a pair 
of scales she hadn't realized that I 
had lost so much in such a short time 
(and with me crying such a great 
deal!) These new mothers! — it's not 
always an advantage to be a "first." 

I was all set, I thought. My doctor 
had left orders that my lactic acid 
formula (boiled, acidified milk, curdled 
for easier digestibility) was to be 
thickened with rice pablum. I was 
to be propped up with pillows in a 
high Fowler's position to see if that 



This nursing care study was written 
by Miss Pavan during her pediatric 
affiliation as a senior student at St. 
Joseph's Hospital, Guelph. 



would help me to keep my formula 
down. But it didn't. Well, anyway it 
was the latest in comfort. Later on in the 
evening, when I was certain that every- 
one had forgotten that my feeding was 
due, along came a nurse and strapped 
a test tube to me. This would be easier 
on the diapers I supposed, as well as 
on the nurses ! 

Next morning the fun really began. 
A new nurse came in and tried to make 
friends in a real hurry. No wonder, 
all she wanted was to make my toe 
bleed ! Then I had no sooner closed 
my eyes when I had company again. 
He turned out to be a doctor who had 
been sent by our family doctor to see 
me. I was promptly transported to 
the treatment room where Dr. Barry 
poked me again and again in my 
tummy. His first remark was that I 
"looked" like a "pyloric" (and having 
lost some more weight didn't help the 
situation any !). 

Then there was some talk about 
waves ! He turned to the student nurse 
and asked if she knew what my symp- 
toms should be. She replied emaciation, 
loss of weight, projectile vomiting 
and peristaltic waves. "Exactly what 
kind of waves," he queried, "everyone 
has visible, peristaltic waves." She 
seemed bewildered. I tried to tell her 
that they were reverse peristaltic waves 



120 



THE CANADIAN NURSE 



since that was the only kind I had 
ever known. I reahze now that this 
was abnormal. Then the doctor pro- 
ceeded to feed me and poke my tummy 
at intervals. Yes, those special waves 
were certainly there along with some 
kind of firm, hard mass about the size 
of an almond which, on palpation, was 
felt going from left to right. Dr. Barry 
was quite convinced that it was pyloric 
stenosis. Just as if to verify his 
thoughts, up I spit (although I didn't 
want to) clear over the side of the 
table ! 

At that same time Dr. Kay entered 
and they started talking about such 
things as surgery, dehydration and 
loss of skin elasticity (the results of 
becoming all dried up!) My laboratory 
reports which I didn't understand at 
all went something like this : 

Hematology: Hemoglobin 108%, WB 

C 13,600. Urinalysis: Alkaline reaction, 

occasional epithelial cells, 1-2 pus cells, 

ammonium phosphate crystals present. 

They finally concluded that I should 
go down to the x-ray department for 
a barium swallow to confirm the diag- 
nosis. 

Whatever that was going to be I 
felt it would be bad enough and was 
already working myself into a sweat 
when to my horror I heard Dr. Barry 
tell the nurse to prepare for a cut- 
down ! That was it, I was sure ! My 
leg was strapped securely to some im- 
movable object to keep me from mov- 
ing so the cannula would stay in the 
vein and all I could remember after 
that was a sharp prick. In a matter of 
minutes it was all over. Dr. Barry 
gave explicit orders that the solution 
of 5% glucose in water and 5% glucose 
in saline was to run at 25 cc. per 
hour or the equivalent of 6 gtts. per 
minute. He went on to explain that 
too much fluid could be just as dan- 
gerous as a deficiency in that I could 
develop a fatal pulmonary edema. The 
nurse was also cautioned to observe 
carefully for signs of muscular twitch- 
ing due to tetany which results with 
a loss of chlorides from the body in 
which case calcium must be immediate- 
ly administered. 

From the way everyone was buzzing 
around I just knew there was some- 
thing else brewing. The next thing I 
knew I was eagerly sucking a new for- 
mula that someone from x-rav had 



been so kind as to make up for me. Oh, 
such a tasteless, chalky mixture to feed 
to a starving infant ! It was only a 
matter of seconds until up it all came 
to the dismay of everyone around 
me. The next step entailed a quick 
change from the treatment room, down 
the elevator onto another floor into 
another dark room only to be fed that 
awful formula again. The doctor here 
stated that there was a marked dila- 
tion of my stomach with apparent ob- 
struction at the pyloric end. Surely 
all this inhuman treatment was bound 
to end soon. 

I had had a most trying day and 
could hardly wait to get to sleep. 
They must have read my mind because 
the next thing I knew I was trans- 
ferred to another bed with a glass top 
and sideview. My, it was nice and 
warm in there ! Mommy and Daddy 
had made fancy plans for my baptism 
that was to have taken place the fol- 
lowing Sunday but since I was sched- 
uled for the operating room the next 
day. I was baptized in the hospital. 
The next morning they started to 
work on me bright and early. This 
time when the lady with the tube tray 
jabbed my toe, I overheard something 
about being typed for cross-matching.* 
Following this a very petite nurse 
came along and slipped a long narrow 
tube into one of my nostrils. I sim- 
ply swallowed it in order to get it 
out of the way! Before I had time 
to worry or fret, I was whisked away 
to the operating room and put fast 
asleep. Peace at last! 

I don't remember too much about 
what happened during the rest of the 
afternoon. I was so drowsy. In one 
instance, I remember that same little 
nurse suctioning my throat and how 
much better it felt after it had been 
cleared of all that mucus and the tube 
had been removed. Then I listened 
while my doctor told her about what 
he had done to me. 

Pyloric stenosis is a narrowing or 
tight constriction of the lumen through 
the pyloric orifice of the stomach which 
produces an obstruction, more often 
partial than complete. Two factors cause 
constriction. One is hypertrophy of the 
circular muscle about the pylorus, and 
the other is spasm of this muscle. Pro- 
jectile vomiting is the chief symptom. 
Jimmy is a typical case being a one- 



FEBRUARY, 1959 • VOL. 55. No. 2 



121 



month- old, male infant. Pyloric stenosis 
occurs about three times more frequent- 
ly in male than female infants and ap- 
pears to involve first-born children 
primarily. It does not usually appear 
before two to three weeks after birth 
or after two- months of age. 

The operation that we performed to- 
day is' the one of choice for this con- 
dition and is known as the Fredet- 
Rammstedt operation. It consists of an 
incision through the hypertrophied circu- 
lar muscle down to, but not through the 
mucosa, and parallel to the pyloric 
lumen, thus allowing the pylorus to 
expand. 

All this meant very little to nie 
but I became most attentive when I 
heard the word "formula" mentioned. 
A schedule to start four hours post- 
operatively, had been made out for 
me in which I would be given alternate 
feedings of two drams of glucose then 
two drams of formula (full-strength 
lactic acid milk). This was to be in- 
creased by two drams every feeding 
every four hours thereafter until two 
ounces were reached. Should I vomit, 
the next feeding would revert to the 
amount I had last retained and work- 
up again. I was to be fed slowly with 
"*a small-holed nipple and feedings were 
to be interrupted frequently for bubbl- 
ing. At the end of the feeding I was to 
be placed on my right side to lessen 
the emptying time of the stomach, and 
also to prevent any aspiration of 
vomitus. My but they were fussy! 
My feedings did stay with me and I 
could tell everyone was so pleased 
I was so thankful that at last my doctor 
had straightened everything up. I long- 



ed to tell him so, but I was a little 
too young then. 

Oh, I had my difficulties with bouts 
of emesis after some feedings, but I 
had a lot of mucus in my throat that 
I just had to get out. Just retaining 
part of my formula was a whole new 
experience for me and that is prob- 
ably why even the addition of Nes- 
targel to thicken my formula didn't 
really help too much. Actually all I 
needed was a little bit of time to get 
adjusted. 

A small dressing covered the in- 
cision on my tummy. The nurses would 
peek at it now and then for any sign 
of bleeding. I was given antibiotics 
to prevent any infection from develop- 
ing. I managed to progress quite 
favorably, and with the appearance of 
one soft yellow stool, the nurses seemed 
very pleased and said something about 
resumption of peristalsis. They must 
have sensed my hunger because on the 
third postoperative day sugar prepa- 
ration was added to my formula and 
the amount was increased to one and 
one half ounces every two hours and 
gradually to three ounces every three 
hours the following day. Now I was 
really living ! 

Before I realized it, it was time 
to go home. Although I was ever so 
grateful to everyone for taking care 
of me so faithfully, (I now weighed 
a pound more than my birth weight!), 
I was very happy to see Mommy. The 
nurse told her to be sure to burp me 
often when feeding me, to keep a clean 
dressing on my incision and to be sure 
to see doctor for a checkup before too 
long. 



Norsins Sisters' Association 



Appointed to the National Executive of 
the Association were : E. Purdy, Dartmouth, 
N.S., pres. ; E. Pepper, Ottawa, past pres. ; 
M. Halibnrton, Halifax, vice-pres. ; D. B. 
Lodge, Ottawa, vice-pres. ; H. Corbett, Vic- 
toria Gen. Hosp., Halifax, sec.-treas. ; A. 
Egan, 85 Walnut St., Halifax, corn sec. ; M. 
J. Russell, Halifax, social convener; Mmes. 
M. C. Macdonnell, Halifax, L. Vatcher, 
Dartmouth, councillors. Honorary presidents 



are: Mrs. S. Ramsay, Montreal and Misses 
E. L. Smellie, A. Mac lead, Ottawa. 

The following members were elected to 
office at the annual meeting of the Halifax 
Unit, held in conjunction with the Armistice 
Day dinner : Mrs. L. Vatcher, pres. ; Mrs. 
M. C. Macdonnell, vice-pres. ; Mary Romans, 
treas. ; Mary Eraser, sec. ; Mrs. Vera Fien- 
dal, convener, sick visiting; Mrs. S. A. 
Bushell, convener, entertainment. 



122 



THE CANADIAN NURSE 



Irsing Care in Hemorrhoidectomy 



Patricia Rowland 

Hemorrhoids 

HEMORRHOIDS OR "PILES" COnsist of 
varicosities in the hemorrhoidal 
veins in the rectum. There are two 
types — internal and external hemor- 
rhoids. Internal hemorrhoids are those 
occurring in the superior and middle 
hemorrhoidal veins. They are found 
within the rectum or prolapsed through 
the anal sphincter and are covered 
only by rectal mucosa. External hemor- 
rhoids are those originating from the 
inferior hemorrhoidal vein and occur 
outside the anal sphincter being cover- 
ed by anal skin. 

The etiology in almost every case 
has proved to be a congenital or he- 
reditary weakness of the venous struc- 
ture that has been aggravated by one 
of the following conditions : 

1. A direct or local pressure on the 
veins of the rectum caused by: 

a. poor bowel hygiene, for example 
chronic constipation 

b. pelvic or abdominal tumors either 
benign or malignant 

c. a pregnant or misplaced uterus 

2. A central obstruction of venous re- 
turn due to : 

a. decompensated heart failure 

b. cirrhosis of the liver. 

The weakness may be present but 
hemorrhoids are not usually found in 
children. However, it is a very com- 
mon ailment among adults of all ages 
with the most frequent causes being 
pressure upon the veins from preg- 
nancy and/or poor bowel hygiene. 

The blood supply to the rectum is 
returned via the inferior, middle and 
superior hemorrhoidal veins that emp- 
ty into the common iliac veins. Like 
other veins, the hemorrhoidal veins 
consist of three layers — intima, media 
and adventia. Veins are thinner-walled 
than arteries and less elastic due to 
the poorly developed medial layer. The 
veins have many tiny semilunar valves 
which form the advential layer. These 
numerous valves do not obstruct the 
return flow of blood to the heart, but 



Misr. Rowland will graduate this year 
from General Hospital, Belleville, Ont. 



they do prevent a backflow. 

When the blood flow is obstructed 
due to local or central pressure, the 
volume of blood in the veins builds up. 
The task of trying to force blood up- 
hill is difficult enough without added 
burden. The inability of the veins to 
cope with the obstruction results in a 
breakdown of the valves. The veins 
become dilated, tortuous, and elongat- 
ed. Hypertrophy of the medial layer 
takes places followed by atrophy and 
replacement fibrosis. The intima and 
adventia layers also become fibrosed 
and thickened. As thickening is ir- 
regular, pouching occurs in the vein 
wall. Thrombosis in these pouches is 
common. Internal hemorrhoids fre- 
quently prolapse through the anal 
sphincter causing considerable discom- 
fort ; if the blood within them clots and 
becomes infected they are said to 
be thrombosed. 

When thrombosis takes place or in- 
ternal hemorrhoids prolapse there is 
considerable pain. This is often called 
an "attack of hemorrhoids." Ordinari- 
ly, there is pain in the passage of stool 
and there may be itching and burning 
sensations between and especially after 
defecation. Internal hemorrhoids often 
bleed at defecation. The amount of 
bleeding may range from a few drops 
to several ounces. If bleeding is allow- 
ed to persist over a long period, second- 
ary anemia may result. 

The Patient 

One spring evening a tall thin gentle- 
man Mr. Stone, was admitted for elective 
surgery of internal and external prolaps- 
ed and thrombosed hemorrhoids. 

Since his birth, 48 years before, he 
had lived and worked in a lumbering 
district. Family financial diflficulties made 
it necessary for him to leave school 
when a boy of twelve. A boy doing a 
man's work does not produce the 
healthiest specimen of mankind, and this 
certainly proved the case for young 
"Jim" Stone. A very poor diet, meals 
at irregular times, little or no health 
teaching in the large family at home, 
resulted in generally poor health and a 



FEBRUARY. 1959 • VOL. 55. No. 2 



123 



rather scrawnily built man. However, 
Jim developed his skill as a lumber- 
jack and at the age of twenty decided to 
go into the business for himself. Long 
hours of backbreaking labor proved 
worthwhile to him as he was able to 
support a wife and a family of three 
boys and two girls. He never mention- 
ed any clubs to which he might have 
belonged but spoke briefly of family 
get-togethers around the fireplace and of 
the occasional visit to the little church 
near his home. 

Mr. Stone was introduced to his fellow 
patients and the evening nurse explained 
to him the hospital routine so that he 
would have some idea what to expect 
and thus would be more at ease. 

Medical History 

His admission temperature, pulse, and 
respirations were normal but his blood 
pressure was only 90/56. He was very 
pale and thin. 

His family history disclosed a mark- 
ed tendency towards anemia. His father 
had had hemorrhoids but had never 
received medical attention. Upon ques- 
tioning he told us that his mother had 
been bothered by the veins in her legs 
and by sores on her ankles. These 
were most likely varicose veins and 
ulcers which stem from the same venous 
weakness as do hemorrhoids. Mr. Stone's 
living circumstances had been partially 
responsible for his slide into poor health 
habits. In childhood he had had the 
usual diseases but had always seemed 
to be ill with them longer than normal. 
For the past 15 years he had been expe- 
riencing severe pain and bleeding on 
defecation. Thus over the years he had 
often disregarded the urge to defecate 
to prevent the discomfort he knew would 
ensue. Chronic constipation and increas- 
ed pain and bleeding during defecation 
proved to be the result of his efforts 
to overcome the condition. 

Mr. Stone had not been to a doctor 
about his condition until now when he 
found that he could no longer endure 
the constant itching, burning, and severe 
pain. He realized, too, that lately he 
tired more easily, that his work seemed 
increasingly strenuous. 

Diagnostic Procedures 

When the doctor vLsited, he did a 



rectal examination to determine the 
location and extent of the hemorrhoids. 
Although it was very evident that 
hemorrhoids were present, bright blood 
in the stool is an important clinical 
sign. The doctor realized the great 
importance of searching the alimenta- 
ry canal thoroughly for other causes 
of the bleeding such as cancer of the 
rectum, bleeding ulcer, or hiatus hernia. 
He ordered a barium enema and x-ray 
of the lower colon on the following 
day. For this test it is very important 
that the lower bowel be completely 
emptied. Otherwise particles of fecal 
material might lead to a wrong diag- 
nosis. This cleansing was done by giv- 
ing Mr. Stone enemas until the return 
soap suds solution was clear. 

A gastrointestinal series of x-rays 
were also ordered for the following 
morning. The nurse explained to Mr. 
Stone that he was not to eat or drink 
after midnight and that he could have 
no breakfast the following morning, in 
order that the x-rays might be accurate. 
To make sure no one tempted him 
with food she hung a "no breakfast" 
sign on his bed. 

Following the x-rays, low residue 
diet was ordered for Mr. Stone in 
order that the fecal content or bulk 
would be small and the hemorrhoids 
less irritated. 

Tuinal grains 3 was ordered as a 
sedative so that Mr. Stone might ob- 
tain a good rest prior to surgery. As- 
pirin phenacetin compound with co- 
deine grains ^4 was ordered for pain. 
Wyanoid rectal suppositories were also 
ordered three times daily for the same 
reason. Wyanoid is an analgesic com- 
pound prepared in cocoa butter. The 
cocoa butter melts at body temperature 
releasing the analgesic compound. 

Several laboratory tests were order- 
ed for Mr. Stone. They were urinaly- 
sis, white blood count, hematocrit, 
prothrombin time and standard test for 
syphilis. (Sec next page) 

The x-rays proved to be negative 
for any abnormalities. Since the patient 
must drink a barium solution for the 
gastrointestinal series, a laxative was 
ordered that night and the following 
morning to clean out the bowel as 
barium can be very constipating. 

During his second day, Mr. Stone 
developed a cold. He began to ex- 
pectorate thick, yellowish blood-streak- 



124 



THE CANADIAN NURSE 



TEST 



RESULT 



NORMAL 



1. Urinalysis 
color 

specific gravity 
albumin 



clear, bright yellow clear, straw-colored 
or amber 

1.019 1.005-L025 

negative negative 



sugar, microscopic examination of 

sediment for casts, red blood cells, and pus cells negative 



negative 



Significaucc: 

a) Abnormalities of color may denote such things as hemorrhage of the urinary system ; or 
disorder of the liver or gall bladder since bile is noted in the urine at an early stage. 

b) Sugar in the urine might denote that the person was a diabetic. 

c) Pus cells would denote the presence of infection in the body or kidneys. 

2. White Blood Cell Count 12.900 per cubic 5,000-9,000 per 

millimeter of blood, cubic millimeter. 

Significance : 

The white blood cell count increases under certain circumstances, for e.xample infection 
and leukemia. The increase in Mr. Stone's white blood count was due to infection that might 
be present in the thrombosed hemorrhoids or from some other source in the body. 



3. Hematocrit 



37% 



45% 



Significance: 

The hematocrit measures the number of packed red blood cells per cubic millimeter of 
blood. Mr. Stone has had rectal bleeding for some years which accounts for the hematocrit 
being slightly low. 



4. Serum Test for Syphilis 



negative 



negative. 



Significance: 

This is a standard blood test done on all patients entering the hospital to discover and 
prevent the spread of venereal disease. 



5. Prothrombin Time 



20 seconds. 



15-30 seconds. 



Significance: 

This test showed that Mr. Stone's prothrombin time was normal. Prothrombin is impor- 
tant in the clotting process ; if the time is longer than normal vitamin K would be given to 
lessen the bleeding time since vitamin K influences the production of prothrombin in the liver. 



ed phlegm and was coughing consider- 
ably. The nurse telephoned the doctor 
who postponed the operation until the 
cold had cleared up. Mr. Stone was very 
sensitive and embarrassed about his 
condition, and was anxious to have the 
operation done. The nurse had to ex- 
plain to him that although the operation 
was a minor one, a heavy cold such as 
his could easily develop into post- 
operative hypostatic pneimionia. Air. 
Stone's anemic condition also render- 
ed him more prone to infection. He 
was not considered a good operative 
risk. 



Penicillin with streptomycin grams 
y^ was ordered to overcome his cold. 
It was to be given twice daily by intra- 
muscular preparation. 

Syrup of codeine was ordered for 
his cough. Tablets of aspirin phena- 
cetin compound with codeine were or- 
dered to relieve the headache accom- 
panying his cold and to keep his tem- 
perature down. 

Two days later Mr. Stone was much 
better. He was given a chest x-ray 
to make sure that his lungs were clear 
and to see if definite operative plans 
could be made. He was also given an 



FEBRUARY, 1959 • VOL. 55, No. 2 



125 



intramuscular injection of vitamin K 
to lessen the danger of hemorrhage. 
Vitamin K stimulates the synthesis 
of prothrombin by the liver. This is 
important in the clotting process of the 
blood. 

Clotting Process: When injury oc- 
curs : thromboplastinogen forms thrombo- 
plastin 

thromboplastin + calcium + pro- 
thrombin forms thrombin 
thrombin -f fibrinogen forms fibrin 
fibrin + cells of blood forms clot. 

Preoperative Care 

The operative area was shaved thor- 
oughly by the orderly. It is necessary 
to remove all the hair since bacteria 
are harbored in it. The colon must be 
clean so that there will be no bowel 
movements for a few days to give the 
operative site a chance to heal. A bowel 
movement too soon after operation 
would cause pain, trauma and hemor- 
rhage. 

Mr. Stone was given his usual dose of 
Tuinal grains 3 in order to get a good 
night's rest. At 7:00 the following 
morning, morphine grains 1/6 and 
hyoscine grains 1/150 were given 
hypodermically. Morphine is given 
preoperatively to enhance the action 
of anesthesia as it depresses the central 
nervous system. Hyoscine is given to 
dry secretions of the mouth, throat 
and nose thus preventing their aspira- 
tion. Mr. Stone had not been allowed 
to have anything by mouth since mid- 
night; thus any previous food would 
have left the stomach by the time of 
operation. At 8:00 a.m. he was taken 
to the operating room. 

The Operation 

Sodium pentothal five percent was 
given intravenously as an induction 
anesthesia. It is rapid in action and is 
used mostly for induction or for very 
short operative procedures. The recov- 
ery from pentothal is quick but occa- 
sionally it causes a mental depression 
that lasts for several hours. 

Mr. Stone was further anesthetized 
with nitrous oxide and oxygen given by 
mask. Nitrous oxide is one of the oldest 
inhalation anesthetics known. It is 
given with oxygen because when given 
alone it may produce asphyxia. 



For the operation Mr. Stone was 
placed in lithotomy position. Before 
being draped with sterile drapes the 
area about the rectum was cleansed 
well with sterile water, Phisohex, and 
merthiolate tincture. The operation 
consisted of ligation of the base of the 
hemorrhoid and then amputation. In 
this manner internal and external 
hemorrhoids were removed from three 
different areas about the rectum. A 
vaseline pack and a catheter were in- 
serted into the rectum to keep the anal 
sphincter dilated and allow for drain- 
age of any internal bleeding. This also 
makes it easier to recognize hemor- 
rhage as otherwise it may be insidious. 

Proctocaine was injected intramus- 
cularly at several points proximal to 
the anus. Proctocaine is similar to 
novocaine in that it is a local anesthetic 
but it is prepared in an oil base so that 
it is long-acting. It is effectual for 24 
to 48 hours. The dressings were held 
in place by a firm T-binder. 

Nursing Care 

Mr. Stone was taken to the recovery 
room where he could be closely watch- 
ed until he had recovered from the 
anesthetic. His pulse and blood pres- 
sure were checked frequently to denote 
the presence of shock or hemorrhage. 
A rise in pulse or a drop in blood 
pressure are signs of hemorrhnge. His 
dressings were also checked frequent- 
ly for excessive bleeding. His pulse 
remained stable at 80 and his blood 
pressure at 110/64. 

Upon his return to his room the 
vitamin K was repeated to insure 
against hemorrhage. It was the nurse's 
responsibility to check for bleeding 
and to check the pulse and blood pres- 
sure every hour for eight hours. 

During the next few days, Mr. Stone 
experienced a great deal of severe rectal 
pain. He was given morphine grains % 
every three hours as necessary. It has 
i:)Owerful analgesic properties and so 
it is very useful for relief of pain. 
However, with certain individuals, very 
little relief is obtained from it. The 
nurse noticed that the morphine was 
not giving Mr. Stone much relief. She 
notified the doctor who changed the 
order to Demerol 100 mgm. to be given 
intramuscularly every four hours as 
necessary. Demerol is a synthetic drug 



126 



THE CANADIAN NURSE 



that often gives relief to those who do 
not get it from morphine. It is not 
as constipating as morphine though it 
is habit-forming. 

The penicilHn and streptomycin in- 
jections twice daily were continued as 
a prophylactic measure against infec- 
tion. 

The nurse encouraged Mr. Stone 
to breathe deeply and to cough oc- 
casionally in order to expand his lungs 
and prevent any upper respiratory 
infection. She also encouraged him to 
move about in bed especially exercis- 
ing his legs to prevent formation of a 
thrombus. Mr. Stone obeyed these in- 
structions very well needing only an 
occasional subtle reminder from the 
nurse. He was started on a fluid diet 
that was gradually increased to soft on 
the second day and to a full diet on 
the third postoperative day. 

Preoperatively the nurse had notic- 
ed that Mr. Stone rather neglected 
good health habits. Health teaching 
had to be done in such a way that 
Mr. Stone would be learning without 
realizing it and his pride in himself 
would not be hurt. As she was bathing 
him, they discussed general good health 
and hygiene. The nurse stressed the 
importance of well balanced, nutritious 
meals and the importance that diet 
plays in the regular emptying of the 
bowel. She told him that good bowel 
hygiene was important to prevent re- 
currence of the hemorrhoids. At meal 
times she pointed out what she had 
meant by a well balanced diet. 

During a visit from his wife Mr. 
Stone introduced her to the nurse who 
remained for a moment to become 
acquainted with her. Before she left 
Mrs. Stone asked the nurse if there 
was anything she could do to help. The 
nurse explained what she had told Mr. 
Stone. She suggested to Mrs. Stone 
that she could encourage good health 
habits and also prepare nourishing 
rather than just filling meals. Sufficient 
rest was also important to her hus- 
band's general health. This he obtain- 
ed in the hospital but would he at 
home? Mr. Stone was not getting 
any younger. In the next few years 
he would have to cut down on the 
amount of labor he could do. He no 
longer had children to support and he 
had younger men working for him who 
could graduallv assume the more 



strenuous tasks. All these little sug- 
gestions the nurse also discussed with 
Mr. Stone, hoping that he would con- 
sider them when he returned home. 
During his stay in hospital the 
several visits of Mr. Stone's minister 
seemed to encourage him although he 
would ne\er have admitted it. He did 
not have many visitors and often be- 
came very moody around visiting 
hours. He appeared to feel out of tune 
with the busy hospital routine compar- 
ed to his freedom in the bush. Only 
once did he take his feelings out in 
rage. It seemed to give him a sense 
of .satisfaction that just once he had 
■'ruffled the quiet feathers" of the busy 
hospital schedule. 

Mr. Stone's progress was very good 
in the days that followed surgery. 
He was turned from side to side for 
comfort or given a rubber air ring 
to take the pressure off the rectal area 
when lying on his back. On the second 
postoperative day the rubber drain and 
\aseline pack were removed. A digital 
examination was done. Diothane oint- 
ment was then inserted into the rectum 
and whenever necessary for discomfort 
thereafter. Diothane is an analgesic 
anesthetic ointment used to relieve rec- 
tal pain by dulling the sensory pain re- 
ceptors in the area. Mineral oil was 
ordered every morning and evening to 
soften the fecal material so that a bowel 
movement would not traumatize the in- 
cisions. Thirtv cubic centimeters of 
mineral oil was ordered lo be instilled 
into the rectum prior to evacuation 
to facilitate the passage of stool. 

Mr. Stone was \ery anxious lo be 
uj) and about. The doctor explained 
how the veins of the rectum would 
dilate and that undue jiressure on them 
from the upright position at tliis point 
might cause hemorrhage. This simple 
explanation satisfied ^Ir. Stone who 
settled back on his pillows \Vithout 
a word. 

On the third postoperative day he 
was given bathroom privileges and 
began Sitz baths twice daily. Sitz baths 
consist of soaking the body in moder- 
ately hot water, covering the hips. 
These baths jirovide much relaxation 
and comfort to the sore area of the 
rectum. The heat increases the blood 
supply, speeding up the healing pro- 
cess. 

\[v. Stone had no difficultv voiding 



FEBRUARY. 1959 • VOL. 55. No. 2 



127 



postoperatively. This is frequently a 
complication after a hemorrhoidectomy. 
He would have been catheterized had 
he been unable to void after all other 
nursing measures had been tried. 

He had a bowel movement on the 
fourth postoperative day with pain but 
no bleeding. From then on he had 
bowel movements daily with little 
trouble. He continued to take Sitz 
baths twice daily. By the time Mr. 
Stone could go home he was eating 



a full diet, and had established good 
bowel habits, to both of which he 
promised to adhere. 

Surprisingly enough he had adapt- 
ed himself to his surroundings. Instead 
of the rather moody person he had been 
upon arrival he was quite jovial, get- 
ting much enjoyment out of expound- 
ing in great detail his many harrowing 
experiences in the bush. He was dis- 
charge a healthier and happier man 
than he had been for sometime. 



Mission to Japan 



Hazel F. Naudett 



To VISIT Japan at any time would 
be wonderful. To do so under the 
sponsorship of two great organizations 
such as UNESCO and the Canadian 
Nurses' Association was an unforgetta- 
ble experience. The East-West Cultural 
Mission was organized by the United 
Nations Association Committee for 
UNESCO under the chairmanship of 
Mrs. Helen Tucker. The aim was to 
further UNESCO's long range pro- 
gram of promoting mutual apprecia- 
tion of East-West culture. 

UNESCO has long maintained that 
since wars begin in the minds of men, 
it is there that the defences of peace 
must be constructed. Certainly, under- 
standing is the foundation stone for 
such defences and how better can we 
learn to understand one another than 
by getting to know each other as indi- 
viduals. 

Our mission of 30 members was 
made up of representatives of educa- 
tional, cultural and industrial fields 
from British Columbia to Quebec. The 
fact that we represented such a variety 
of interests and were a cross section 
of Canadians — ordinary citizens — 
was of interest to the Japanese people 
who interpreted this as real democracy. 



Miss Naudett who is superintendent 
of Listowel Memorial Hospital, Lis- 
towel, Ont. and president of District 2, 
R.N.A.O. represented the Canadian 
Nurses' Association on the East-West 
Cultural Mission to Japan. 



From the moment that our plane land- 
ed on the runway at the Haneida Air- 
port, Tokyo until we wistfully said 
"Sayonara" four weeks later we were 
surrounded by kindness, courtesy and 
hospitality beyond anything that we 
could possibly have anticipated. The 
careful planning of the Japanese Na- 
tional Commission for UNESCO as- 
sured us a program of significant and 
enjoyable activities. 

National organizations in Japan 
cooperated with the National Commis- 
sion for UNESCO in arranging lec- 
tures, receptions, visits to industries 
and sight-seeing so that we could make 
the very most use of our time. The 
day of our arrival the chairman of 
the Japanese UNESCO Commission, 
Mr. Tamon Maeda, gave a reception 
at the beautiful Prince Hotel in Tokyo. 
This gave the Canadians the oppor- 
tunity to meet members of the minis- 
tries concerned with cultural affairs, 
education, and international relations 
as well as members of the National 
Commissions for UNESCO, UNICEF, 
the United Nations Associations. Inter- 
national House, and the Japan-Canada 
Society. 

On our second day, Mr. lyemasa 
Tokugawa, former ambassador to Ca- 
nada and presently president of the 
Canada- Japan Society, entertained at 
dinner where men and women out- 
standing in industry were presented. 
Trade with Canada is a major concern 
since Japan buys twice as much from 



128 



THE CANADIAN NURSE 



Canada as she sells. Canada on the 
other hand, would like to sell more 
hard wheat to Japan. 

Our group was honored by an of- 
ficial welcome at the semiannual meet- 
ing of the Japanese National Commis-- 
sion for UNESCO. In her reply on be- 
half of the mission, Mrs. Tucker said, 
"It is the work of UNESCO in your 
country and mine, to bring the right 
meaning to the words we exchange. 
This is education in its true sense 
— understanding of the heart, as well 
as of the words spoken by the mind." 

One of the outstanding lecturers 




Japanese thnic'uuj 

presented to the Canadians was Dr. 
Yukio Yashiro, world renowned art 
critic, who addressed the group on 
"The Japanese Scroll" at the Society 
for International Cultural Relations. 
Among the social highlights was the 
magnificent outdoor reception given by 
the Ministry of Foreign Affairs with 
Mr. Akira Miyazaki, Director of the 
U.N. Bureau, as host. This was held 
at "Happoen" formerly owned by the 
Imperial Family. The reception at the 
Canadian Embassy, given by Ambas- 
sador and Mrs. William Frederick 
Bull, featured the famous koto per- 
former, Mr. S. Yuize. The koto is 
an ancient harplike instrument, placed 
horizontally and played from a stand- 
ing position. 

Travel and sight-seeing were made 
easy and interesting by the topnotch 
guides of the Japan Travel Bureau. 
The absolutely punctual train service 
required baggage transfers in two 
minutes flat. The significance of 
shrines, temples and national treasures 
was explained in apt and oftentimes 
humorous English by a former history 
professor who was our guide through- 
out the tour. 

Before going on the tour that took 



the group to Hiroshima University 
and the International Peace Library, 
our mission was entertained at a uni- 
que luncheon by the International 
Women's Association. The setting was 
the mansion of the Iwata Iron and 
Steel Co. and the hostess, Mrs. Emiko 
Ojima, wife of the president. The Tea 
Ceremony was demonstrated in the 
teahouse set apart in the garden espe- 
cially for that purpose. Flower ar- 
rangements and Japanese dancing were 
taught in the conservatory. The lunche- 
on itself was a culinary masterpiece 
of Japanese soup, tempura (prawns 
fried in deep fat), vegetables and 
exotic delicacies. We were greatly im- 
pressed by the skill, charm and' am- 
bition of the Japanese women in pre- 
senting the culture of the Japanese 
family to the foreigner. 

On our tour, a holiday was ar- 
ranged in a beautiful new Japanese- 
style hotel in the mountains above 
Hakone. Although the aftermath of 
a typhoon prevented sports and view- 
ing from the cable car, we relaxed 
in mineral baths, Japanese style. The 
hot deep bath, up to the chin, is a 




A Lesson in floiver arrangement 

positive treatment for weary muscles, 
jagged nerves and aching joints. That 
daily bath keeps the Japanese free from 
rheumatic pains. 

Several days were spent among the 
historic treasures of Kyoto and Nara, 
the former capitals of Japan. Kyoto 
because of its national treasures, was 
not bombed during the war and now, 
by vote of its citizens, is considered 
"The Peace City." Unusual effort is 
made to make international friends. 



FEBRUARY, 1959 • VOL. 55, No. 2 



Our party was divided into groups of 
five and, equipped with interpreters, 
visited private homes. These personal 
home visits were most instructive 
and enjoyable. This service is looked 
after by a special department of the 
city government. Then we travelled 
through miles and miles of luxuriant 
farm land, meticulously manicured into 
gardens of tea, rice and bamboo, 
peopled from dawn to dark by hatted, 
stooping figures. 

In Hiroshima we were greeted at 
the railway station by flowers from 
the Mayor and a guard of honor of 
local Boy Scouts. We went directly 
to the University where President 
Tatsuo Morito and officials had ar- 
ranged the ceremony for the presen- 
tation of books and UNESCO gift cou- 
pons to the International Peace Lib- 
rary. Mrs. Tucker delivered the main 
address to which President Morito 
and representative students replied. 

After inspecting the University 
buildings — many makeshift or in 
process of construction, we visited the 
Hiroshima Memorial and silently and 
solemnly placed the gift of flowers. 
The program did not include a visit 
to the museum. It was explained, 
"What we would see there is disastrous- 
ly awful, it is not pleasant." The 
following day we went on an early 
tour of Miyajima Itsukushima Shrine 
and its Tori Gate in the sea. Lunch 
later and speeches by the Deputy- 
Governor of the Prefecture, the Mayor 
of the city and Dr. Morito who assured 
the Canadians of the very real ap- 
preciation that the Japanese people 
felt for the compliment paid them by 
such a visit from Canada. Here, de- 
termination that peace shall be main- 
tained, vibrates the very air. We stop- 
ped at Osaka, Japan's second city, upon 
our return to Tokyo. A night at the 
Osaka Grand Hotel, brand new and 
as smart as any in this country, gave 
us an opportunity to evaluate our 
experiences and plan the last week of 
free time. 

As a nurse I was interested in the 
welfare of the Japanese people. In 
Japan, in the early postwar years, 
there was a tremendous increase in 
the number of persons seeking social 
aid and medical services. National 
concern for improvement in the social 
security system is steadily mounting. 



All political parties have shown a 
positive interest in expanding its be- 
nefits. Japan has many laws pertain- 
ing to social security : The Livelihood 
Security Law (for needy persons) ; 
Law for the Welfare of Disabled Per- 
sons ; Child Welfare Law (for children 
in need of health protection) ; Health 
Insurance Law (for employees) ; Na- 
tional Health Insurance Law (for 
everyone) ; Unemployment Insurance 
Law and Welfare Pension Insurance 
Law (for employees). The number of 
beneficiaries under the public aid pro- 
gram totals two million persons. 

Extensive preventive efforts are 
being made to combat tuberculosis, 
one of the most serious diseases in 
Japan today. Under the Tuberculosis 
Control Law. all students, employees 
in offices and factories and persons 
under 30 years of age living in desig- 
nated areas, are required to undergo 
tuberculin reaction tests and x-ray 
examination. However, tuberculosis is 
very much on the decline in Japan as 
it is in Canada. 

Japan has a total of 5,418 hospitals 
for her 90 million people. There are 
31,390 nurses for government health 
centres and a total of 224,486 nurses 
and 86.554 midwives. People with 
whom I had contact, assured me that 
they had a sufficient number of hospital 
beds. These hospitals are attended by 
efficient stafifs, many of whom have 
received postgraduate courses on the 
North American continent. Hospitals 
have no shortage of registered nurses 
and qualifications are much the same 
as ours in Canada. The minimum edu- 
cation required to enter a training 
school for nurses is the equivalent of 
our Junior matriculation. 

Salaries for general duty nurses 
are about $50.00 a month in Canadian 
money. Salaries or wages of all 
Japanese people are much lower than 
in Canada for a comparative position 
or job. The salaries of nurses are 
in accordance with the Japanese scale 
of income. A factory worker would 
get $20 a month and one in an execu- 
tive position would get $100. It is 
interesting to note that most hospi- 
tals have a policy that all their nurs- 
ing staff must live in the hospital 
residence. 

Through the courtesy and influence 
of Mr. Shu Tomii, former minister of 



1.W 



THE CANADIAN NURSE 



Foreign Affairs to Canada, a complete 
tour of Tokyo Kosei Nenkin Byoin 
(The Tokyo Welfare Pension Hospi- 
tal) was arranged. This is a 500-bed 
general hospital, modern in archi- 
tecture and design and having modern 
equipment similar to what we have in 
Canada. It has five stories. The first 
two floors are mainly for the outpatient 
department and the remaining three 
floors are for inpatients. The hospital 
is open for all types of patients, not 
only health-insured but private patients 
as well. 

One could write a great deal about 
a trip like this but space does not 
permit. The 93 hours of flying time 
took me across Canada to Cold Bav, 



Alaska ; Tokyo, Japan ; Hong Kong ; 
Honolulu, Hawaiian Islands, back to 
Vancouver and finally Toronto. When 
one has been privileged to be daily 
with men and women of another race, 
to come to know them as friends, bar- 
riers of race and color disappear. 
One's attitude toward them can never 
be the same again. There wasn't one 
of us who did not feel a responsibil- 
ity to make the Japanese better known 
and better appreciated in Canada. As 
for the UNESCO major project, 
"Mutual Appreciation of Eastern and 
Western Cultural Values," the Cana- 
dian mission says with one voice, "You 
cannot do better than to start with 
Japan." 



In the r.ood Old Days 

{The Canadian Nurse — February, 1919) 



From an editorial quoted from the Ameri- 
can Journal of Medicine : The war and the 
epidemic of influenza with the consequent 
scarcity of nurses, have drawn attention to 
the trained nurse and to the fact that she 
does not supply the suitable agent for minis- 
tering to the large body of the ill. The 
very poor may get free nursing . . . the rich 
can, and will, pay whatever may be demand- 
ed; but the large mass of people of moderate 
means . . . must be deprived of her services 
or secure them at what is often a ruinous 
sacrifice. 'More than this, a nurse of the 
highly trained type is not necessary, or even 
desirable, in the vast majority of cases of 
illness. 

The editor answered: This condition 
where the people of moderate means find the 
fee asked by the nurse a burden does un- 
doubtedly exist ; but do not these same people 
complain loudly and long at the charges of 
the doctors? The family doctor no longer 
exists ; but an army of specialists, each with 
his ample fee, awaits the sick person. One 
does not hear the medical profession crying 
out that there shall be two standards of 
medical education — one to take the higher 
work, and the second grade to take charge 
of the chronic and similar cases where, 
indeed, it is difficult to get the first-class 
physician to take much interest. 



Hospital trustees are realizing that the 
class room and laboratory are fundamental 
parts of the equipment, and that an over- 
worked superintendent of nurses, whose chief 
duty is administration, cannot be expected 
to prepare lessons and conduct classes as a 
side issue . . . Some of us are wondering if 
the visiting instructor may not find her place 
here . . . There is a long list of hospitals 
needing full-time instructors, and not enough 
women to send to them. 

* * * 

In one hospital an instructor was asked 
to give a course in chemistry. No space 
could be found except the board room where 
eventually the lectures were given while ex- 
periments where conducted in the small lava- 
tory opening off the main room. One young 
miss handed in her experiments marked 
"Lavatory Notes !" 

* * * 

Natural sleep is ushered in by slow, 
shallow breathing. It is therefore recom- 
mended that the person trying to go to sleep 
should breathe slowly and not too deeply. 
Sleep usually follows. 

* * * 

Thirty necklaces have been made from the 
pearls given by the women of the Empire 
for the benefit of the Red Cross. Many of 
the pearls have historic associations. 



FEBRUARY. 1959 • VOL. 55. No. 2 



131 



Irsing Profiles 



Ethel Crawford Shaw was appointed 
regional director for Nova Scotia and New- 
foundland with the Victorian Order of 
Nurses in the latter months of 1958. A 
graduate of the Hospital for Sick Children, 
Toronto in 1943, she is a native of Wetas- 
kiwin, Alberta and received her early edu- 
cation in that province. 

Miss Shaw was a nursing sister in the 
Royal Canadian Army Medical Corps for a 
period of one year before going on to the 
University of Alberta to obtain her diploma 
in public health nursing. In 1947 she com- 
pleted the requirements for her B. Sc. N. 
and more recently, 1957, she obtained her 
Master of Science degree from Simmons' 
College, Boston. Her professional duties 
have been associated almost exclusively with 
public health work. For si.x years she was a 
staff nurse with the City of Calgary Health 
Department attached to the school health 
service. Experience in a Child Hygiene Clinic 
was followed by her appointment to the 
Montreal Branch of the V.O.N, in 1957. She 
remained here until she received her present 
appointment. 

She has always taken an active and in- 
terested part in professional activities, as 
secretary-treasurer of the Alberta Public 



Health Association for two years, president 
of the Calgary chapter of the A.A.R.N. for 
a similar length of time and, most recently, 
as an executive member of the Nova Scotia 
Section of the Canadian Public Health 
Association. Off duty she is an enthusiastic 
sportswoman with hiking, skiing, swimming 
and badminton as favorite activities. Play- 
ing bridge, reading and photography are re- 
served for more leisurely moments. 

Dorothy Maud Hibbert has been ap- 
pointed assistant professor in charge of the 
program in administration of nursing services 
sponsored by the W. K. Kellogg Foundation 
at the University of Saskatchewan, Sas- 
katoon. 

Born in Manitoba, Miss Hibbert is a 
graduate of the General Hospital, Winnipeg, 
class of '2>7. In 1944 she obtained her 
certificate in teaching and supervision from 
the University of Manitoba; in 1953, her 
B.Sc. in administration of nursing services 
from Teachers College, Columbia Univer- 
sity, and in 1957, her M.A. in administration 
of nursing education from the same institu- 
tion. This past year she completed the 
requirements for a professional diploma in 
graduate nurse education at Teachers College 
after receiving a Kellogg fellowship. 

Miss Hibbert has had cfMisiderable practi- 




(Pau\ llorsdal Ltd.—Ottau'a) 

Ethel Crawford Shaw 



132 



Dorothy Maud Hibbert 

the canadian nurse 



cal experience in nursing service adminis- 
tration. Shortly after graduation she joined 
the staff of her hospital as a general duty 
nurse, later becoming a head nurse — a po- 
sition that she filled for several years. In 
1948 she was appointed an instructor and 
supervisor in surgical nursing and in 1950 
she became the director of nursing services 
at W.G.H. Miss Hibbert was a member of 
the board of managers of the MARN for 
approximately five years, interrupting her 
term of office briefly for postgraduate study. 
In addition she was a member of the nursing 
service committee of the district association 
for two years. 

In her leisure time, she enjoys her mem- 
bership in the Soroptomist Club, the Univer- 
sity Women's Club and similar organizations, 
and helps in the work of the Women's 
Auxiliary of her church. Stamp collecting, 
handwork and gardening, "all in moderation," 
help to fill any spare moments. 

After 30 years of service with the Vic- 
torian Order of Nurses for Canada, Dorothy 
Fowler lias retired. 




(The Smith Studi< 

Dorothy Fowler 



-Amherst) 



A Maritimer by birth, she took her pro- 
fessional training at Newton Hospital in 
Newton Lower Falls, Massachusetts. This 
was followed by postgraduate study in public 
health nursing at Columbia University. Miss 
Fowler first joined the V.O.N, in 1928 after 
experience as a staff nurse at Highland View 
Hospital, Amherst, N.S. and in public health 
nursing .south of the border in West Virginia. 

She began her career with the V.O.N, as 
a staff nurse in Halifax and over the years 
she has been nurse-in-charge of branches in 



Kentville, Sydney arid Sackville, Nova Scotia 
and Moncton, New Brunswick. In 1953 Miss 
Fowler was appointed the regional director 
for Nova Scotia and Newfoundland. A sense 
of humor, an immense fund of energy and her 
interest in her work carried her through a 
regime of constant travel and work, especial- 
ly during the years since her appointment 
as regional director, that would have exhaust- 
ed many. Everywhere she went, she made 
friends for herself and the organization that 
she has so ably represented. Her retirement 
will be regretted by her colleagues, friends 
and patients but the good wishes of all are 
extended to lit-r i'<v •-■..•(. haii])infss. 



-'■*%i^ 




An .xo.xciade Bergiko.x 
Annonciade (Martineau) Bergeron 

retired from her position as chief nurse in the 
City Health Department erf Montreal in Oc- 
tober, 1958. The loss of her services in public 
health nursing will be felt keenly but free- 
dom from professional duties has made it 
l)Ossible for Mrs. Bergeron to enjoy her new 
home in Shawinigan, P.Q. and her activities 
as a housewife. 

Her interest in public health began short- 
ly after her graduation from Montreal's 
Notre-Dame Hospital. After four years with 
the Brown Paper Company at La Tuque, 
she did postgraduate study at the University 
of Montreal. Some time later she spent a 
year at Teachers College, Columbia Univer- 
sity. 

Her association with the Montreal Depart- 
ment of Health began in 1928 when she was 
appointed supervisor in the division of com- 
municable disease control. It was interrupted 
temporarily while she acted as interim 
director of Ecole d'Infirmieres Hygienistes 



FEBRUARY. 1959 • VOL. 55. No. 2 



ISS 



at the University of Montreal. She returned 
to the Department in 1942 where she sub- 
sequently served as assistant director and 
then director of nursing services. 

The alumnae association of her hospital, 
the provincial Public Health Section, the 
CNA Public Health Section and the Cana- 
dian Public Health Association Nursing 



Section have all received her active support 
and energetic participation. She is a pasl 
president of the Association of Nurses of the 
Province of Quebec. 

The sincere good wishes of her friends 
and former colleagues in the nursing profes- 
sion are extended to Mrs. Bergeron for her 
future happiness. 



in iHemoriam 



Annie Black who graduated from the 
Hamilton General Hospital in 1917, died in 
October, 1958. She had engaged in private 
nursing for a short time before illness forced 
her retirement at an early age. 

* * * 

Phyllis Margery Dart, a graduate of 
Guy's Hospital, London, England in 1917, 
died in Hamilton, Ont. on November 30, 
1958. She served during World War I as a 
member of the Queen Alexandra Imperial 
Nursing Service in the Dardanelles, Egypt 
and South Africa. Miss Dart came to 
Hamilton in 1923 and joined the staff of the 
General Hospital as a head nurse. She retir- 
ed in July, 1957 but continued to give part- 
time service until shortly before her death. 

* * * 

Gretta MacKay Ross, a graduate of the 
General Hospital, Toronto in 1919, died on 
December 12, 1958. She was in charge of the 
social service department of the Hospital for 



Sick Children, Toronto before going to Bed- 
ford College, London, Eng. where she took 
advanced study in public health nursing. On 
her return to Canada Miss Ross became the 
first Director of Nursing and Camps for the 
Ontario Society for Crippled Children. Three 
camps were opened under her supervision. 
She retired from this position in 1953. 

* * * 

Catherine G. (Marshall) Hawkins died 
in August. 1958 in Hay River, N.W.T. 

* * * 

Kathleen (Stowzinski) Hopfner who 

graduated in 1956 from St. Boniface Hospital, 
Winnipeg died in Winnipeg in October, 1958. 
Mrs. Hopfner was on the stafif of Johnson 
Memorial Hospital, Gimli, Man. at the time 

of her death. 

* * * 

Beatrice M. Knechtel, a staff member of 
the South Waterloo Memorial Hospital, 
Gait, Ont., died on November 3, 1958. 




Joan (Nixon) Morrison who graduated 

from the General Hospital, Hamilton in 1951, 

died in June, 1958. 

* * * 

Gerald Roth who graduated from the 
General Hospital, Hamilton in 1942 died 
on March 23, 1958. After a short time spent 
in general duty at H.G.H. and St. Mary's 
Hospital, Kitchener, Mr. Roth joined the 
staflF of the Freeport Sanatorium, Kitchener 
where he remained until his death. He was 
a member of the executive of the Ontario 
Male Nurses' Association. 



G RETT A MacKay Ross 



Clare Waller who graduated from the 
General Hospital, Hamilton in 1911, died in 
.\ugust, 1958. She had engaged in private 
nursing until she retired in 1932. 



If God be lor us who can be against us. 
— Holy Bible, Romans \'III. 



She speaks, yet she says nothing. 

— Wm. Shakespkakk 



134 



THE CANADIAN NURSE 



The Past has a Future 



Albert W. Wedgerv, Reg.N 



THERE IS ONE QUESTION that I am 
asked frequently, both within and 
outside the profession, and for which, 
as a matter of defence, I have long 
since prepared an immediately reply : 
"Do you believe there is a future for 
men in nursing?" A ready affirmative 
on my part, supported by a few terse 
but emphatically stated reasons why 
I feel there are abundant possibilities 
for men in the nursing profession 
usually engenders a facial response 
which implies grave misgivings about 
my sanity. Whenever I encounter this 
anticipated unfavorable reaction, my 
only consolation is to remember that 
to most people (including many who 
should know better) the contemplation 
of a nursing career for a man seems 
illogical, if not downright fantastic. 
In the face of such undisguised men- 
tal opposition I have found that it 
is often much wiser to let the unin- 
formed go their incredulous way rather 
than disperse one's energies on a not- 
always successful barrage of persuasion 
and enlightenment. 

It is strangely ironic that this 
modern tendency to reject nursing as 
an appropriate and acceptable type 
of work for men reflects so closely 
the unfortunate position in which 
women found themselves less than a 
hundred years ago, if they dared to 
dream of nursing as a suitable oc- 
cupation for their sex. One need only 
recall (with humor now) the wave 
of revulsion and hysteria that swept 
the family circle every time Florence 
Nightingale broached the matter of 
training as a nurse. Yet, when the 
long, bitter struggle against prejudice 
and ignorance had been won through 
Miss Nightingale's unceasing perse- 
verance, nursing became so inseparably 
identified with women that a new pro- 
fessional concept slowly and inevitably 
took shape. Thus, what had at first 
appeared impractical and doomed to 

Mr. Wedgery is operating room super- 
visor at the General Hospital, Oshawa, 
Ontario. 



failure in the face of violent antagonism 
in official circles, proved in the end to 
be the redemption of thousands of 
women who sought in nursing a worthy 
and satisfying outlet for their talents 
and energies. • 

While it may not be entirely just to 
label Miss Nightingale's persistent 
campaign against Victorian sensibili- 
ties as an "accident of history," there 
is no gainsaying the fact that her 
ultimate victory has created the false 
impression in succeeding generations 
that nursing has always been an ex- 
clusively female vocation. Despite much 
historical evidence to refute this mis- 
guided belief, there has grown up in 
the public mind a far too ready ac- 
ceptance of nursing as a type of work 
which can best be performed by women 
and in which men can have no valid 
interest. Consequently, many young 
men whose temperaments and abilities 
would make them valuable additions 
to the nursing profession find them- 
selves out of line with the cultural 
patterns of our present century. In 
other words, where once public opinion 
had been, on the whole, unsympathetic 
to the notion of gentlewomen training 
as nurses, so now it continues to up- 
hold a tradition and sentiment that 
have the dubious value of keeping the 
nursing profession almost restricted to 
female practitioners. 

Essentially, then, the whole question 
of a brighter future for men in nursing 
in this country revolves around the es- 
tablished cultural beliefs and customs 
of the present day. Even in this re- 
markably progressive era of our civili- 
zation, owing to the prevailing sharp 
division between what are deemed con- 
ventional male and female occupations, 
it is sometimes risking social disappro- 
bation to pursue any career that does 
not fit into the accepted mould. Oddly 
enough, though women have invaded 
many fields of work that a half century 
ago were acknowledged inaccessible 
citadels of masculine employment, there 
has been a surprising reluctance in 
many quarters to encourage men to 



FEBRUARY. 1959 • VOL. 55. No. 2 



135 



seek careers in those areas that are 
commonly regarded uniquely female 
callings. Nevertheless, in those in- 
stances where men have crossed the 
imaginary barrier and found personal 
satisfaction and happiness in work that 
is orthodoxly considered female, they 
have often achieved conspicuous suc- 
cess and given undeniable proof that 
men are able to perform these duties 
equally as well as women. 

Is it not time, then, to cast off 
the shackles of tradition that hinder 
nursing from realizing its full pro- 
fessional potentialities? Should we not 
discard these outworn impediments 
that have no rightful justification today 
and look the matter of recruiting more 
men into nursing squarely in the face? 
Once we can get a clear picture of the 
singular opportunity presented to the 
nursing profession to make possible 
worthwhile and permanent careers for 
young men, we shall perceive that the 
present disposition to retain outmoded 
sentiments would seem to place nursing 
in a somewhat static and unprogressive 
position. 

At the present time the few men, 
comparatively speaking, who embark 
upon nursing careers in Canada are 
very much in the same circumstances 
as women who enter the medical and 
legal professions. In both situations 
these individuals, who feel a distinct 
call to their respective fields and 
are brave enough to risk being thought 
eccentric and noncomformist, (although 
this is less true today in the case 
of female doctors) pursue their vo- 
cations vastly outnumbered by mem- 
bers of the opposite sex working in 
the same professional territory. Fur- 
thermore, in each instance, until they 
have proved themselves capable and 
reliable practitioners in a new en- 
vironment, there is often an unwitting 
inclination on the part of their co- 
workers to look upon them as curi- 
osities, or at best, misfits. If this seems 
too se>'ere an appraisal of the predica- 
ment facing these dedicated men and 
women, I think vou will agree, at 
least, that while there appears to be 
a great deal more reciprocity nowadays 
in these virtually restricted occupa- 
tions (teaching has long been the 
notable exception in this regard), there 
is still enough adverse sentiment of 
this kind tainting these respected pro- 



fessions to cause discomfort and dif- 
fidence in those determined souls who 
encroach upon the hallowed precincts. 

Therefore, anyone who approaches 
the matter of recruiting more men 
into the profession, with a realistic 
appreciation of the difficulties of such 
a task, will be faced with the im- 
mediate problem of convincing the 
general public, and the male portion 
in particular, that nursing is not an 
efifeminate and unnatural vocation for 
men. For one thing, history reminds 
us that the military orders, which were 
founded during the Middle Ages to 
care for the sick and needy, were 
comprised solely of men trained spe- 
cifically for this philanthropic purpose. 
It is especially worth remembering, 
too, that the institution of chixalrous 
virtues such as obedience, discipline, 
and devotion to duty by these Knights 
Hospitallers have become an integral 
part of our nursing legacy from a far- 
away time when the burden of caring 
for sufifering humanity fell equally 
upon the shoulders of both men and 
women. If contemporary proof is need- 
ed for the process of re-educating the 
public one need only consult the pres- 
ent record for ample confirmation that 
men are making, and will continue to 
make, a distinctive contribution to 
the nursing profession. Across Canada 
in general hospitals, in schools of nurs- 
ing, in mental and penal institutions, 
in the public health field, and in in- 
dustry, men are now occupying impor- 
tant positions as directors, supervisors, 
instructors, and head nurses, in ad- 
dition to others who are employed as 
general staflf nurses. In those rlaces 
where men are supervising and direct- 
ing staffs comprised of one or both 
sexes there prevails, more often than 
not, a wholesome atmosphere of ef- 
ficiencv and cooperation thnt is some- 
times jacking in situations where femi- 
nine leadership is not always able to 
cope with problems of incompetence 
and insubordination. Moreover, it has 
been proved that there is unques- 
tionable vnlue in having men in such 
administrative posts because their un- 
interrupted careers as nurses produce 
a long-range employment that cfi^ects a 
stabilizing influence within the profes- 
sion itself. 

It is. I suggest, this necessary ele- 
ment of stability which more men in 



136 



THE CANADIAN NURSE 



its ranks could give to the nursing 
profession. This appears to be the car- 
dinal feature of recruiting them into 
this sphere of work. To intelligent and 
far-sighted young men, with a genuine 
calling to this field, nursing could be- 
come a lifetime occupation in which 
they would find satisfying rewards and 
the proper incentives to grow profes- 
sionally. To many young women, on 
the other hand, nursing is a valuable 
and treasured steppingstone to mar- 
riage, a home, and a family, a com- 
mendable ambition which few will dis- 
pute but an objective that annually robs 
the profession of hundreds of trained 
personnel. In spite of the great num- 
bers of women who graduate from our 
schools of nursing each year, there is 
no alleviation of the now chronic short- 
age of nurses, an apparently irremedi- 
able situation that gives every indi- 
cation of becoming more acute as hospi- 
tal services expand. Even if only 
small groups of men were turned out 
each year, they would help in some 
way to fill the gap left by those nurses 
who desert their vocation, for it is con- 
versely true that marriage and domestic 
responsibilities, providing remuneration 
is adequate, would not have the same 
effect on their budding careers. Thus, 
there is every reason to hope that large 
numbers of men, who could have a 
stabilizing and salutary influence on 
the profession, would help to establish 
a firmer foundation for Canadian nurs- 
ing as it explores new pathways in 
service and education. 

Notwithstanding these pertinent pos- 
sib'lities, however, it must be re- 
membered that if nursing is to at- 
tract its share of ttalent among young 
men (and women) it must expect con- 
stant and vigorous competition from 
other occupations, especially in regard 
to monetary returns. Nowadays, with 
few exceptions, recruitment into any 
type of work is influenced by re- 
muneration and terms of employment, 
two basic points that may well spell 
the answer to the chronic inability 
of the profession to overcome the pres- 
ent shortage of graduate nursing per- 
sonnel. No matter how sincerely a man 
may want to become a nurse, he is not 
likelv to endure a long period of train- 
ing (unless there is a personal reason 
for doing so) if the rewards and op- 
portunities at graduation are not equal 



to other occupations demanding no ap- 
prenticeship and less responsibility. 
While present salaries show a striking 
improvement over those of the im- 
mediate post-war years, nursing must 
not relinquish its constant struggle to 
bring its pecuniary compensations more 
into line with other professional 
groups. In short, if nursing hopes to 
meet fully its expanding obligations, 
it must make every effort to retain 
adequate numbers of trained personnel 
by assuring them of truly professional 
benefits. 

All the same, there are small but 
obvious signs that the men in nursing 
today are enjoying the gradual but 
welcome recognition of the special role 
which they can play in professional 
affairs and activities. As every year 
sees an increase in the number of male 
nurses who have come to this country 
from Great Britain and Europe to seek 
a new livelihood and a new profes- 
sional outlook, it is not unreasonable 
to expect these men to want some share 
in formulating the plans and policies 
of nursing in their respective com- 
munities. In Ontario, which boasts the 
first committee of male nurses in the 
history of Canadian nursing, it is 
heartening to report that men are now 
sitting as members of the permanent 
committees of the Registered Nurses' 
Association of Ontario. Each year at 
the annual meeting of that organization 
the registration of men has increased 
to the point where what was once virtu- 
ally a sea of feminine faces has now 
become pock-marked with small spots 
of masculine invaders equally intent 
upon the proceedings. 

An even more important move in 
this direction has taken place recently 
in Nova Scotia where a man has been 
appointed chairman of one of the main 
committees of the provincial nursing 
association — a forward step which 
shows not only enterprise but also faith 
in the future contribution that men can 
make to their calling. It is. I believe, 
indicative of a realistic trend of thought 
in provincial nursing affairs that in the 
brochure, "A New Day," which was 
prepared for the opening of the new 
headquarters of the R.N.A.O., the fol- 
lowing significant statement appears : 

in it will work, and in it will study, the 
men and women who are dedicated to the 



FEBRUARY. 1959 • VOL. 55. No. 2 



137 



raising of standards of nursing education 

and service. 

Ten years ago, perhaps even five, 
this confident assertion would have 
been unthinkable so little part did men 
take in nursing activities. Today, it 
opens not only a new door to the future 
for men in nursing in Ontario but also 
serves as a guide to other provinces 
where men may be waiting and eager 
to share in shaping the course of their 
profession. 

Does it seem strange to you now 
that I remain steadfast in my belief 
that few other professional fields offer 
better opportunities to the right men 
than nursing does today? In what 
other field at the moment does there 
exist such an alarming shortage of 
trained personnel with the likelihood 
that the inception of government- 
sponsored hospital insurance schemes 
will create an even greater demand for 
competent practitioners? All in all, 
there are unlimited possibilities in the 
variety of available positions, each of 
which will depend upon personal inter- 
est, initiative, and proficiency. Further- 
more, it is clearly evident that nursing 
is taking the necessary steps to raise 
its financial position from the present 



uninspiring level so that it can com- 
pete more favorably with other pro- 
fessional and non-professional occupa- 
tions. If this happy objective is reach- 
ed in the near future, there is no logical 
reason why men should not find in 
nursing all the essential attractive con- 
ditions for security and advancement. 

Today, while fundamental and often 
revolutionary changes are taking place 
within nursing that will set the pattern 
for future developments, there is no 
better time for rededication to the 
cherished ideals of our highly-respect- 
ed profession. It is an excellent time, 
also, for re-evaluation of the methods 
and devices employed to recruit per- 
sonnel so that every potential candidate 
for training, male or female, will not 
fail to find in nursing those profes- 
sional and personal rewards that are 
the hallmarks of a worthwhile vocation. 

Lastly, it is an opportune time for 
a renewal of purpose throughout the 
profession, for a broadening of our 
professional horizon so that, side by 
side, men and women can share in the 
steady progress of nursing as it strides 
forward confidently to meet the unfore- 
seeable problems of this challenging 
centurv. 



fireetinss from the M President 



In extending my good wishes to nurses 
throughout the world, I am reminded that in 
most countries this is a season for giving 
arid receiving gifts. As nurses, we treasure 
our privilege of "giving" generously to those 
for whom we care. May we strive for in- 
creasing wisdom to give with such under- 
standing and compassion that the receiving 
of our gifts will bring comfort and joy as 
well as improved health. 

To achieve our goals we need to work 
closely with all of our colleagues in the 
health team and to develop an understanding 
of the general public. For this we shall 
need the help and the facilities of our na- 



tional nurses' associations. 

Through this greeting I send my good 
wishes to our member organizations and to 
each of the nurses whom they represent. I 
am confident that by giving strong support 
to your association in the coming year you 
will give more efifectively to the patients 
and the community, and the citizens will 
continue to receive richly throughout this 
year, and the years to come. 

Affectionate greetings to each member for 
an active and eventful 1959. 

Agnes Ohlson 

President 

International Council of Nurses. 



Peptic ulcer tends to be worse in the 
period from October to March. During these 
months there is usually less opportunity to 
follow outdoor interests and to relax from 
the day-to-day grind . . . People do not seem 
to have the feeling of well-being that they 



have in the sunny months of the year . . . 
There is a psychogenic factor involved in 
the formation of peptic ulcer and any con- 
dition that affects the individual's feeling 
of well-being will have an effect on ulcer 
symptoms. — American Journal of Nursing 



138 



THE CANADIAN NURSE 



fifSffiRCH 



The Master Plan of Rotation 

Margaret M. Street, B.A. 

(Concluded from the January 1959 issue.) 



Administration of the Plan 

1. Postings: From the Master Plans 
of Rotation for all classes, postings 
may be made once monthly, or as 
deemed advisable. For example, at the 
end of November, 1958, postings may 
be made for the months of January 
and February, 1959 or for one month 
only, if preferred. 

Mimeographed copies of the post- 
ings for all wards and departments 
will then be sent to head nurses, 
supervisors, clinical instructors, the 
nurses' residence, the associate di- 
rectors of nursing education and nurs- 
ing service, the student health service. 

2. Program revisions for individual 
students may become necessary through 
illnesses, leaves of absence, etc. These 
are made on an individual basis, ac- 
cording to the particular circumstances 
of the case. Generally speaking, it is 
advisable for the student, after the 
initial adjustment of program, to carry 
on with her rotations according to the 
original plan. However, this may not 
be advisable, in which case more com- 
plete readjustment of program must be 
made. Everyone concerned must be 
advised of any changes in postings 
which have been made. This is pro- 
ably best done by memoranda, rather 
than by telephone. 

3. Use of Master Plan by clinical 
instructors for all classes, is a help- 
ful tool in assessing the learning needs 
of the individual student, and in plan- 
Miss Street is Associate Director of 

Nursing of the Calgary General Hospital 
School of Nursing. 

FEBRUARY, 1959 • VOL. 55, No. 2 



ning her ward teaching program in ad- 
vance of her coming to the ward. The 
instructor can see at a glance what 
previous experiences and classes the 
student has had, whether she will be 
returning at a later date to this same 
service, and, if so, when. She is alerted 
to the special needs of the student 
arising out of her background of ex- 
perience and instruction. For instance, 
a young intermediate student, entering 
a general surgical ward, may have had 
the following experiences between the 
time she finished the Medical-Surgi- 
cal Block, in May, and the time she 
enters general surgery: holidays, four 
weeks; central supply room, two 
weeks ; diet kitchen, six weeks ; oper- 
ating room, eight weeks ; and general 
medicine, four weeks. She has had 
very little bedside nursing experience 
since the block, and will require care- 
ful guidance and supervision in nurs- 
ing care, in the administration of 
medications, etc. The clinical instruc- 
tor then has the responsibility of ad- 
vising the head nurse, team leaders 
and other staff regarding the back- 
ground of this student and her special 
needs. 

A clinical instructor in medical nurs- 
ing, consulting the Master Plan in 
advance of a student's coming to the 
ward, will be able to ascertain how 
much experience of this kind the stu- 
dent has had, and how much she will 
have later. This, in turn, makes it 
possible for her to plan a program 
for the student at the level she has 
reached. 

It should be noted that the clini- 
cal instructors — in seeking infor- 
mation about the background of the 



130 



student and her progress to date — 
will wish to consult, also, the Clini- 
cal Experience Monthly Record Book, 
and the Clinical Progress File of the 
student. It is helpful if these sources 
of information are all kept in one 
office, that of the Clinical Coordinator 
or person doing the rotations. 

4. Withdrazmls constitute a prob- 
lem of greater or lesser magnitude, 
in administration of the Master Plan, 
depending upon the number, and where 
they fall on the plan. Generally speak- 
ing, it is advisable to adhere to the 
original plan. This is possible only 
in a situation where stabilization of 
the service is not dependent upon stu- 
dent nurse service. Stabilization of 
service by general staff nurses and 
nursing aides is vital to the success- 
ful administration of the Miister Plan 
and of the educational program as a 
whole. 

5. A major principle of first im- 
portance in the administration of the 
Master Plan is that students are not 
moved for service needs from the area 
to which they have been posted to an- 
other area where there may be a short- 
age of staff. Graduates or nursing 
aides may be moved, to stabilize ser- 
vice needs, but not students, other- 
wise the educational program of the 
student is seriously disrupted. 

6. If curriculum revisions in the 
educational program for a particular 
class should be deemed essential — 
and major revisions of a program once 
planned should be relatively few — 
this mav necessitate redrawing the 
Master Plan, which is a very difficult 
matter. It seems advisable to hold 
firmlv to the curriculum pattern es- 
tablished for any one class, and to 
undertake revisions for succeeding 
classes instead. However, it is in- 
advisable to hold to a pattern which 
experience has revealed to be faulty, 
and revision of the Master Plan to 
make possible the correction of weak- 
nesses appears justifiable. 

7. The Master Plan is reznezved 
thoroughly at the end of the second 
year. 

Ev.XLUATION OF THK MaSTKR Pl.\N 

The final test of the Master Plan 
is the progressive development of the 
student in the program, and thus the 



sahsfactory achievement of the aims 
of the educational program. Evalu- 
ation of the Master Plan of Rotation, 
as of other aspects of the total cur- 
riculum, may be made 

a. By the faculty of the school of nurs- 
ing, who are guiding the learning pro- 
cess and closely observing the student at 
every stage of her progress. Such evalu- 
ation should be a constant activity in the 
regular faculty meetings, which are at- 
tended by all instructors, classroom and 
clinical. 

b. By the head nurses, and supervisors 
who have an important share in the 
clinical program of students, the assign- 
ment to them of patient care and relat- 
ed duties, supervision of such activities, 
and evaluation of the students. As cus- 
todians of patient care, head nurses are 
in a unique position to guide and evalu- 
ate students. 

c. By the students themselves. It is 
helpful to receive the evaluation of stu- 
dents about their program, including 
clinical experiences. Students may give 
such evaluations in conferences with 
clinical instructors, with the clinical co- 
ordinator, the associate director of nurs- 
ing education, etc. They may also be 
invited to attend meetings of the faculty 
for the purpose of making recommen- 
dations regarding their program. 

d. The quality of patient care given 
by students and graduates of the school 
is the most sensitive index of the edu- 
cational program, and of the rotation 
plan that is such an important part of 
it. 

e. The satisfaction of patients, their 
relatives and doctors, with nursing care 
given. 

Implications for the 
Nursing Service 

1. Estimating, for budget purposes, 
equated student service hours of com- 
ing fiscal year: The Master Plans of 
Rotation are planned around the learn- 
ing needs of the students, not around 
the meeting of nursing service needs. 
However, it must be recognized in the 
hospital school of nursing, that the 
student gives some service in return 
for her education. Until schools of 
nursing are established on a sound 
financial basis, like other institutions 
of learning, and until student nurses 
pay fees, like other students, we shall 



140 



THE CANADIAN NURSE 



have with us a situation where student 
nurse services are rendered in ex- 
change for their education. However, 
it is essential, if we are to produce 
nurses capable of meeting the complex 
demands of today's program of total 
health care, that buffers be placed in 
the ward situation to protect both the 
care of patients and the learning needs 
of students. These buffers are general 
staff nurses and auxiliaries — certi- 
fied nursing aides, and orderlies. The 
budget of the Department of Nursing 
should make provision for the required 
personnel. 

2. Xursing care is measurable in 
terms of hours per patient day : The 
number of average hours of care in 
a given service of a particular hospi- 
tal depends upon a variety of factors. 

a. The physical plant and facilities of 
the ward and of the hospital. 

b. Services rendered by other depart- 
ments in the total care of patients. 

c. .Age of patients. 

d. Diagnoses of patients. 

e. Plan of medical care (kinds and 
numbers of treatments ordered, medi- 
cations, etc.) 

f. Plan of nursing care (custodial, re- 
habilitative, etc.) 

g. Length of hospital stay, 
h. Prognosis. 

i. Presence of learners in the area 

(student nurses, medical students, etc.) 
j. Research activities undertaken. 

It appears necessary to establish, 
for each ward or service, a standard 
erf patient care, including a statement 
as to the average number of hours to 
be given per patient day, and the per- 
centage of these which will be given 
by professional and by non-professional 
personnel. 

It is also necessary that a record 
be kept, month by month, of the pa- 
tient days in each zivrd. This is used 
in forecasting staffing needs for the 
coming budget year. 

Estimating the staffing requirements 
for a specific ward, for a given budget 
period, becomes a matter of exact com- 
putation, when one is in possession 
of the foregoing particulars, and in 
addition, information regarding the 
amount of student nurse service which 
will be available, equated in terms of 
professional or graduate nurse service. 

In a moment, we shall consider one 
method of computing the amount of 



anticipated student nurse service, but 
first let us see how this information 
may be used, once we have secured it. 

Example: West 5 is a general medical 
and diabetic ward, having both male and 
female patients in public (four-bed and 
six-bed), semi-private and private ac- 
commodations. Number of patient days 
for the last twelve-month period (Sep- 
tember 1, 1957 — August 31, 1958) was 
14,569. This figure will be used for 
budget estimations for the 1959 budget 
year. The standard of care approved for 
this ward is 3.4 hours, of which 65% is 
to be given by professional personnel 
and 35% by non-professional personnel. 
Graduate nurses work 1868 hours at the 
bedside in one year, and nursing aides 
1891 hours. From the Master Plans of 
Rotation, it has been computed that 
student nurses will spend 13,839 hours at 
the bedside, equated in terms of profes- 
sional (graduate) hours. How many 
general staff nurses and nursing aides 
will be required? 

Total nursing hours required for 
14,569 patient days, at 3.4 per patient 
day (3.4 x 14,569) = 49,534.6 

Number of professional nursing hours 
(65% X 49,534.6 = 32,197.49 

Number of non-professional nursing 
hours (35% x 49,534.6) = 17,337.1 

Number of student (equated) hours 
anticipated =z 13,839 

Number of nursing hours to be given 
by general staff nurses (32,197.49 — 
13,839) = 18.358.49 

1868 nursing hours are worked by oue 
general staff nurse in one year. 

18,358.49 hours are worked by 
(18,358.49 -^ 1868) general staff nurses 
= 9.8 (9 — 10) 

1891 nursing hours are worked by one 
nursing aide in one year. 

17,337.1 hours are worked by (17,337.1 
^ 1891) nursing aides. = 9.1 (9) 
Budget computations, may, with 
great advantage, be worked out on a 
four-month basis rather than a yearly 
basis. Such a method will provide for 
stabilization of service in periods of 
heavy class schedules, heavy holidays. 
or graduation, of a large class. 

Ofie Method of estimating available 
student nurse sennce: 

1. From the Master Plans of Rota- 
tion, the anticipated numbers of stu- 
dents in all classes for the coming fiscal 
year are summarized. 

2. Number of .student weeks in each 



FEBRUARY. 1959 • VOL. 55. No. 2 



141 



clinical area is ascertained, both on the 
annual basis, and on the basis of four- 
month periods. 

3. The summary of students of all 
classes anticipated in each ward weekly 
during the coming year is typed, and 
copies are made available to the clinical 
instructors, head nurses, and the asso- 
ciate director of nursing service. This 
summary is of great value in such 
aspects of administration as planning 
staff holidays, vacations of clinical in- 
structors, etc. 

4. Student service hours are com- 
puted from student weeks, as follows : 

Example: Number of equated student 
service hours for Class 1959 (Senior), 
January-April, 1959. 

Total service weeks, estimated Janua- 
ry-April: 33 weeks, or 231 days. 

Total maximum service days, exclusive 
of weekly day off (6/7 x 231) 198 days 
Sick time to be deducted (7/365 x 
231) 4 days 

Statutory holiday time to be deducted 
(3x5^ days) 1.5 days. 

Net days of student service (198 — 4 
sick days — 1.5 statutory holidays) 
192.5 days 

Total hours of duty (8 x 192.5) 1540 
hours 

Estimated teaching time deductible 
(33 weeks x 3 hours per week) 99 hours 
Net hours of senior student service, 
January- April (1540-99) 1441 hours 

Effectiveness factor of senior students 
90% 

Replacement value of students during 
this period (90% x 1441) 1297 graduate 
equivalent hours 

Similar computations can be made 
for the other classes of students using 
the effectiveness factors noted above. 
It has been found advisable, when 
computing service hours of the junior 
class, to allow for a 15% withdrawal. 
This is done at the beginning of the 
computation, that is, the anticipated 



student weeks are brought to days, 
then 15% is deducted therefrom. This 
is a protection to the nursing service, 
since additional staff will be engaged 
as a buffer against withdrawals. 

Conclusion 

From our experience, the Master 
Plan of Rotation has proved to be an 
effective instrument in providing a 
balanced program of clinical experi- 
ence, correlated with instruction, to all 
students. It has made it possible to 
provide all students of the same class 
with comparable experiences. Students 
have expressed satisfaction that they 
know in advance their program as 
planned for the three-year period. They 
are pleased, too, to be able to express 
certain preferences with regard to clini- 
cal experiences (including affiliations) 
early in their first year (before the 
names are put onto the Master Plan) 
and early in the third year when the 
total program is reviewed with each 
student, electives assigned, and, when 
indicated, certain revisions made in the 
third-year program. 

Once the Master Plan hns been 
constructed, which takes one or two 
weeks once yearly, administration of 
it is not difficult. Monthly postings take 
from one to two days. The balance of 
the month may be spent in other activi- 
ties, apart from the small amount of 
time occupied by making minor day- 
to-day adjustments in an individual 
student's program. 

From the point of view of nursing 
service, it has proved to be a valuable 
asset, in estimating staffing require- 
ments for a budget period, to be sup- 
plied in advance, by the faculty mem- 
ber in charge of rotations, with a sum- 
mary statement of the anticipated stu- 
dent inflow into all clinical areas for 
the coming year, and the graduate- 
equivalent hours of nursing service 
which are expected in them. 



One out every 100 Canadians is a dia- 
betic; five out of each 100 over 50 years 
of age have the condition. Forty per cent 
of diabetics are aware that they have it. 
Those who are over 40 years of age, over- 



weight and have a history of diabetes in the 
family are most susceptible. Periodic medical 
examinations will aid in discovering the con- 
dition and permitting treatment to control it. 
— Dept. of National Health and Welfare 



The first entry of a member of Parlia- 
ment with two Christian names occurred in 



1552 — Thomas Maria Wingfield, Hunting- 
don, England. 



142 



THE CANADIAN NURSE 



Organisation et la Conduite d'une ilssemblee 



PaTKICIA DlI'LAIN 



L 



ES HORIZONS de I'hygieniste ne sent 
plus exclusivement limites aux exi- 
gences locales, mais ils sont sou vent 
rallies aux besoins regionaux, provin- 
ciaux, nationaux et parfois meme inter- 
nationaux. Avec 1' expansion tou jours 
grandissante des services d'hygiene pu- 
blique, les transformations democra- 
tiques qu'ils ont subies dans les der- 
nieres annees et les demandes crois- 
santes dn public, les hygienistes - — 
medeciiis, infirmieres, inspecteurs et 
autres — sont souvent appele a pre- 
sider on preparer une assemblee, in- 
teressant le domaine professionnel ou 
extra professionnel. 

II est inutile d'insister sur I'impor- 
tance ca|)itale de la connaissance des 
divers mediums de communication avec 
le grand pid)lic et des mesures scien- 
tifiques c|ui doivent etre utilisees pour 
obtenir pleine efficacite. II ne s'agit 
pas de s'enliser dans une longue dis- 
sertation doctorale, mais pour arriver 
a nn resuUat satisfaisant certaines 
notions elementaires doivent nous etre 
familieres, car il arrive souvent que le 
parrain d'tme bonne cause en compro- 
mette le succes par ignorance des 
regies, d'usage, alors cju'un adversaire 
plus liabile et plus au courant des, tech- 
nicalites en aura facilement raison. 

D'apres les concepts modernes, une 
assemblee est le resultat de develop- 
pements techniques requerant un art 
et une preparation speciale, conver- 
geant vers les exigences de la commu- 
naute. Elle doit etre efficace et com- 
porter tm travail d'equipe et plus 
I'assemblee aura d'envergure, plus 
grande sera I'equipe et aussi plus dif- 
ficile sera la coordination. 

I.'homme etant un etre eminemment 
social, a constate depuis longtemps. 
qu'au contact de ses semblables, il 
enrichissait sa culture et son develop- 
pement, par une association ou un 
echangc d'idees. Les plus anciens re- 
Seminar presente par Mile Patricia 

Duplain sous la direction de Mile Ga- 

brielle Charbonneau, professeur a I'Ecole 

d'Hygiene de I'Universite de Montreal. 



gistres du monde nous decrivent des 
reunions, soit pour feter un chasseur 
victorieux ou pour organiser une stra- 
tegie de guerre. II est meme facile 
d'imaginer que I'homme des cavernes 
devait reunir son conseil autour du 
"feu de camp" pour discuter de ses 
problemes. 

De temps immemorable, la discus- 
sion a semble etre le denouement heu- 
reux de la plupart des assemblees deli- 
berantes. Par sa forme democratique 
d'approche aux interets et affaires de 
la communaute, elle est une source 
inepuisable d'informations et les gens 
y participent ordinairement avec beau- 
coup d'enthousiasme. Poston declarait 
dans "Small Town Renaissance," que 
la discussion franche et amicale par les 
gens eux-memes est le plus court che- 
min pour atteindre leurs problemes 
et qu'aussi longtemps qu'ils pourront 
discuter librement, la democratie sur- 
vivra. Je crois qu'il est a propos de 
faire id une courte revue des diverses 
methodes de discussion les plus em- 
ployees : 

Parlons d'abord de Vntlrevue, qui 
est ce contact individuel entre deux 
personnes se reunissant dans un but 
specifique et bien determine. Forme 
d'approche intime et tres personnelle, 
I'entrevue tend a renseigner I'un et I'autre 
des participants. C'est une methode ideale 
d'education individuelle. 

\'ient ensuite la conference table 
rondc oil trois ou quatre personnes, 
])arfois plus, sont reunies pour dissequer 
un ou plusieurs sujets d'interet commun. 
Un president choisi parnii le groupe est 
responsable de la discussion, il y parti- 
cipe s'il le desire, comme les autres mem- 
bres. II n'y a pas d'auditoire, I'atmos- 
phere est familial et sans formalite. 
C'est un moyen efficace de renseignement 
pour un petit groupe d'une organisation 
et la formule generalement employee 
pour les reunions de comite. 

Tres populaire cbez les anciens Grecs, 
le symposium consiste dans la presen- 
tation individuelle d'un sujet. par deux 
ou plusieurs experts, sous la direction 
d'un president. Le sujet, debattu pendant 



FEBRUARY. 1959 • VOL. 55, No. 2 



environ dix a quinze minutes par cliacun 
des experts, a pour but de presenter 
un probleme sous plusieurs points de 
vue. Apres quoi, I'auditoire peut enoncer 
ses idees et poser des questions. Cette 
methode de discussion est constante et 
flexible dans sa forme et sa haute valeur 
a ete reconnue dans le domaine de I'edu- 
cation publique. 

Suit de pres le forum, prenant forme 
de conference un travail est elabore par 
un expert et des questions, posees par 
Tauditoire, sont dirigees vers les specia- 
listes participant sous la tutelle d'un 
president. II est avantageusement em- 
ploye quand une information est desiree 
sur un sujet sans controverse et qu'on 
recherche les idees d'experts. 

Le panel est une autre methode tres 
en usage de nos jours. II se compose 
ordinairement de trois ou quatre mem- 
bres tenant conversation devant un au- 
ditoire. Le president au centre, sans 
prendre part active a la discussion, la- 
dirige et la clarifie au besoin. Le panel 
est surtout employe devant une assis- 
tance tres nombreuse pour reproduire 
un point deja discute devant un petit 
groupe. La television en a fait un de ses 
spectacles educatifs. 

Tel que vous le connaissez, le seminar 
est la combinaison de recherche indivi- 
duelle et de discussion de groune. L'auto- 
rite decide du sujet a elaborer, un mem- 
bre ou etudiant fait investigation et 
pr^sente un rapport sur la question en 
cause. II s'ensuit une discussion coope- 
rative sous I'egide d'un professeur. Tous 
les etudiants doivent se renseigner sur la 
matiere et prendre part a la discussion. 
Les universites et les centres de re- 
cherches I'utilisent sur une haute echelle. 
Enfin Vinstiiut, cercle d'ehide ou 
"workshop," presente une opportunite 
pour les individus de travailler ensemble 
i la solution de leurs problcmes. II peut 
durer un seul jour ou s'etendre a plu- 
sieurs semaines. Le workshop organise 
dans certaines universites devient verita- 
blement un cours de "rafraichissement." 
Des conferences prennent place dans 
I'avant-midi et I'apres-midi, des petits 
groupes ayant un intcret commun tra- 
vaillent a I'analyse d'un sujet, un rapport 
est redige et presente au groupe entier 
a la fin du "workshop." 
De ces methodes de discussion, le 
symposium et le jorum sont souvent 
employes au cours des assemblees pro- 
fessionnelles ou autres. 



Une simple reunion necessitera 
moins d'elaboration qu'une convention 
de trois jours avec mille delegues venus 
de toutes les parties du monde. Mais 
qu'il s'agisse de I'organisation du plus 
petit cercle d'infirmieres au plus solen- 
nel conclave, une assemblee pour qu'elle 
puisse deliberer validement doit etre 
regie selon certains principes des pro- 
cedures parlementaires, etre orientee 
et dirigee par un chef aide d'un execu- 
tif qui en fera fonctionner le rouage 
effectivement et c'est ici qu'entre en 
jeu le choix des officiers. 

Une organisation ne vaut que par 
le caractere et les aptitudes de ceux 
qui la dirigent, aussi faut-il apporter 
beaucoup de sagesse et de discerne- 
ment dans la selection des membres. 
Un bon comite doit etre varie dans ses 
membres. Les uns, portant a I'oeuvre 
un interet tres sincere, constituent 
des collaborateurs fort actifs, ils 
assistent regulierement aux seances, 
donnent largement de leur temps et 
s'initient aux details du fonctionne- 
ment. lis portent sur leurs epaules 
le poids de I'entreprise. D'autres, ne 
pouvant donner un effort aussi conti- 
nu, apportent tout de meme le concours 
precieux de leur competence technique. 
Enfin, certains ayant une valeur poten- 
tielle plutot que reelle sont trop jeunes 
et trop inexperimentes pour fournir 
une aide effective, ils sont les adminis- 
trateurs de demain qui se forment au 
contact de leurs aines. Leur presence 
est indispensable, car si brillant que 
soit le present, il faut penser a I'avenir 
et I'attachement a une oeuvre ne s'im- 
provise pas. 

L'equipe sera aussi structuree par 
une variete d'age et de sexe. Sans 
porter atteinte au prestige indiscutable 
du sexe fort, il serait parfois souhai- 
table que I'element feminin y soit 
represente, car sur le plan psycholo- 
gique la femme, par sa nature et son 
education, percoit ou con^oit les choses 
de faqon differente et complementaire 
a I'homme. 

Toute preponderance de classe so- 
ciale et de quartier doit aussi etre 
evitee. On ne peut n(^gliger I'influence 
attachee a la position sociale, mais la 
campagne entreprise pour la sante pu- 
blique ne doit pas etre I'apanage d'une 
coterie locale. Si desirable que soit 
la collaboration de chacune des per- 
sonnes composant l'equipe, il sera sage 



THE CANADIAN NURSE 



a gentle laxative that 
will not cause cramps, 
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Available In handy tubes 
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economy sizes for home use. 




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MONTREAL, CANADA 



FEBRUARY, 1959 • VOL. 55. No. 2 



145 



a I'occasion de sacrifier le concours 
de certaines d'entre elles et de s'assurer 
line representation equilibree de tous 
les elements de la population. Les cir- 
constances exterieures ne doivent pas 
etre I'unique critere de cet equilibre. 
II faut dans iin comite et des coeurs 
et des esprits, et les deux ne se ren- 
contrent pas necessairement dans le 
meme individu. 

Le minimum de personnes dans un 
comite doit comprendre un president, 
un vice-president, un secretaire et un 
tresorier. On peut, selon les besoins de 
la cause, y ajouter un president hono- 
raire, un ou deux vice-presidents, un 
secretaire archiviste, un tresorier ad- 
joint et des conseillers, avec un maxi- 
mum limite de 15 a 20 membres, don- 
nant la preference a un nombre impair. 
Ce groupe constitue le bureau de direc- 
tion ou I'executif selon le cas. 

Dans le choix du president, trois 
points sont a considerer: I'experience. 
I'habilete et le temperament. II doit 
etre dynamique, versatile, posseder 
le sens de I'humour et des qualites 
de "chef." Son experience des hommes 
le rendra capable de s'entourer de col- 
laborateurs competents. Son esprit 
sera assez ouvert pour accueillir les 
idees npuvelles. Si, a ces qualites 
s'ajoutent le prestige et I'influence 
conferes par un rang eclatant dans la 
societe, dans les affaires ou dans une 
profession liberale, le choix n'en sera 
que meilleur, car il est le cerveau de 
I'assemblee, "Autant vaut le president, 
autant vaut rassemhlce." 

Parmi les aspirants a la presidence, 
il nous sera donne de voir evoluer 
divers individus a personalites dif- 
ferentes ; nous en etudierons quatre 
genres frequemment rencontres, a sa- 
voir : 

Le type phalliqiic, policicr ou doinina- 
teur, il domine s'impose au groune sans 
toutefois obtenir la collaboration ou la 
sympathie des membres. Une fois elu, il 
attache beaucoup d'importance a son 
titre et aux honneurs qui en decoulent. 
Avec un tel president, Forganisation aura 
a souffrir. 

Le type obscssif se sent en conscience 
le seul a pouvoir tout faire, il ne delegue 
aucune responsabilite a personne. II ap- 
porte grand soin a une multitude de 
details, neglige les grandes lignes et 
perd de vue I'essentiel. Une fois elu. 
il cherche constamment I'approbation. 



Avec un tel president, qu'adviendra-t-ii? 
Le type passif reunit tous les membres, 
les laisse sans directive et croit que tous 
pourront reussir par eux-memes. Alors, 
une fois elu, qui dirigera I'entreprise? 
Enfin de tj'pe actif n'cst pas autocrate. 
II stimule les gens, les encourage a se 
mettre d'accord, a former un groupe, a 
donner leurs opinions et a cooperer acti- 
vement aux decisions du groupe. Une 
fois elu, il sera le president ideal J 
Apres cette breve enumeration, 
libres sont les gens de faire un choix 
judicieux de leur president, car par 
son role, il dirige les deliberations, 
maintient I'ordre et le decorum, re- 
coit les propositions et les soumet a 
I'assemblee, se prononce sur les ques- 
tions de procedures, appelle le vote et 
proclame les resultats, signe les docu- 
ments officiels, confirme les proces- 
verbaux des seances anterieures ap- 
prouves par I'assemblee. II ne prend 
part a aucune decision et ne vote qu'au 
cas d'egalite des voix, alors qu'il a 
preponderance. 

Si le president desire prendre part 
a un debat, il doit laisser le fauteuil 
et y appeler le vice-president ou a 
defaut un autre membre a presider, 
mais il doit s'abstenir autant que pos- 
sible de recourir a cette melhode, afin 
de conserver son prestige d'impartia- 
lite. En cas d'appel de sa decision, il 
a droit d'etre entendu le premier sur 
les dits motifs, sans etre oblige de 
laisser le fauteuil. II resle assis pour 
disposer de la routine, mais il doit 
se lever pour enoncer les propositions 
et pour en appeler le vote. 

Quel role assigne-t-on au vice-pre- 
sident ? II remplit les fonctions du 
president en I'absence de celui-ci ; il 
est souvent appele a presider les re- 
unions de I'assemblee lorsque celle-ci 
siege en comite plenier. La vice-pre- 
dence est trop souvent consideree 
comme un poste purement lionorifique 
et cette attitude presente de grands 
inconvenients. Le progres d'une oeuvre 
est maintes fois paralyse a cause d'un 
offlcier incapable d'assumer, le mo- 
ment venu, les responsabilites que le 
president abandonne temporairement. 
Les qualites personnelles du vice-pre- 
sident peuvent bien se comparer a 
celles du president. 

Quelle est la fonction du secre- 
taire? II envoie les avis de convo- 
cation, prepare I'ordre du jour et 



14« 



THE CANADIAN- NURSE 



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FEBRUARY. 1959 • VOL. 55. No. 2 



147 



communique aux membres les rapports 
des comites, les motions et autres do- 
cuments officiels dont il a la charge. 
A chacune des seances il redige et 
signe les proces-verbaux qu'il soumet 
a I'approbation de I'assemblee. Le pre- 
sident les confirme de sa signature en 
indiquant la date de cette confirmation. 

I^ bonne administration du conseil 
depend beaucoup plus qu'on ne le pense 
de sa competence et la tache du presi- 
dent se trouve considerablement faci- 
litee, s'il a comme secretaire une per- 
sonne sur laquelle il pent se reposer 
pour tous les details du service. Si 
I'assemblee se reunissait sans qu'il y 
ait de president ou de vice-president, 
il est du devoir du secretaire de I'ap- 
peler a I'ordre et de provoquer I'elec- 
tion d'un president provisoire. 

Pour que I'assemblee soit valide- 
ment constituee et conforme aux statuts 
exigeant la presence d'un nombre de- 
termine de personnes, il faut s'assurer 
avant I'ouverture qu'il y a "quorum" 
pendant la duree des deliberations. 
Le secretaire est ordinairement charge 
de cette constatation. 

Quant au tresorier, il s'occupe de la 
comptabilite, prepare et presente le rap- 
port financier. Conjointement avec le 
president, il signe les cheques et autres 
documents concernant les finances de 
I'organisation. Ses responsabilites sont 
grandes et il doit parfois, dans I'exercice 
de sa charge, etre convert par une police 
d'assurance donnant une certaine ga- 
rantie contre les erreurs ou detourne- 
ments de fonds. 

II nous reste a considerer les droits 
et les devoirs des membres. Au cours 
d'une assemblee, les membres passent 
par dififerents stades avant de faire 
vraiment partie integrale d'un meme 
groupe. Cette evolution psychologique 
s'opere par dififerents phases dont la 
premiere appelee phase individuelle, 
est celle ou chacun fonctionne comme 
individu et essaie de se faire accepter 
comme tel. 

Dans la phase d'identification, les 
membres cherchent a faire paire, 
triangle ou chaine avec les autres mem- 
bres de I'assemblee. Puis, processus 
analogue a celui qui se passe chez I'ado- 
lescent, alors que devient adulte, phase 
de narcissisme et de devalorisation, les 
gens surestimes deviennent des statues 
d'argile et ceux que Ton mesestimaient 
sont apprecies a leur juste valeur. 



Enfin, arrive la phase de stabilisa- 
tion ou de productivite. Les partici- 
pants s'acceptent bien comme difife- 
rents et incomplets. Chacun apporte 
une bonne volonte a depersonnaliser 
et a liquider ses conflits en face des 
exigences du travail demande. Tel sera 
le comportement de I'equipe ideale. 

S'il est un terrain ou la liberte 
d'opinion doit s'exercer dans toute sa 
plenitude, c'est bien celui d'une assem- 
blee deliberante. Chaque membre a le 
droit de soumettre ses propositions ou 
motions et de les discuter sans qu'on 
puisse porter atteinte a I'exercice de 
ce droit, mais la liberte n'est pas syno- 
nyme de licence et celui qui veut ex- 
cercer son droit ne pent le faire au 
prejudice de ses collegues. 

Le premier droit des membres est 
bien celui de la liberte de parole. Apres 
avoir dument demande la permission 
au president, le participant doit rester 
dans les bornes legitimes. Ainsi, on ne 
pent interrompre un membre qui a la 
parole, a moins que ce soit pour le 
rappeler a I'ordre ou pour etablir une 
motion privilegiee, legalement admise. 
Les interruptions, les apostrophes, les 
conversations entre les membres ne 
sont pas do mise, surtout si elles ont 
pour efifet de distraire I'attention de 
I'assemblee, et le president veillera 
a I'application rigoureuse de ces pres- 
criptions. 

L'assemblee legalement constituee 
doit done etre regie selon certains 
principes des procedures parlemen- 
taires. lis ont pour but de faciliter et 
d'aider la transaction des afifaires, tout 
en protegeant le droit des membres. 
Ouelques-unes. de ces lois sont essen- 
tiellement techniques et si elles ne sont 
pas comprises, elles peuvent donner 
lieu a la confusion plutot qu'a la bonne 
entente. 

Un premier principe veut que la 
majorite ait force dc loi. La majorite 
dans une assemblee est souveraine et 
ses decisions ont forces de loi sauf en 
certains cas. oil les principes du droit 
des gens sont etablis si fermement, 
qu'il faut une proportion plus nom- 
breuse et parfois meme I'unanimite 
pour les ignorer. Par contre la minori- 
tc doit aussi etre entendue. Ses droits 
de base doivent etre reconnus et res- 
pectees ; elle a droit d'entrer dans la 
discussion et de presenter son oppo- 
sition en temps opportun. 



148 



THE CANADIAN NURSE 



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FEBRUARY, 1959 • VOL. 55, No. 2 



149 



Un autre principe dit que chaque 
motion presentee est sujette a libre 
et entiere discussion. Le proposeur fait 
I'eloge de la motion et en expose tous 
les merites ; de leur cote, les adver- 
saires doivent avoir la meme opportu- 
nity de formuler leur opposition. Ce- 
pendant, il faut ne faire qu'une chose 
a la fois et si plusieurs motions etaient 
presentees en meme temps, il en resul- 
terait une anarchie complete. Le pre- 
sident veillera a I'observation de ce 
principe. Enfin il doit y avoir justice 
et courtoisie pour tous les membres 
presents. Ce principe ne s'applique pas 
seulement au president ou a ses of- 
ficiers, car par son attitude de cour- 
toisie et sa maniere d'agir le president 
devient une saine inspiration pour tous 
les membres. 

Qu'entend-on par motion ? C'est une 
proposition faite par un membre de la 
reunion, c'est une forme de procedure 
des lois parlementaires requises pour 
la transaction des affaires dans un 
corps deliberant. Une motion pent etre 
principale, privilegiee, subsidiaire ou 
incidente. Elle doit etre presentee selon 
la procedure suivante : 

Un membre se leve et s'addressant 
au president, il s'identifie puis enonce la 
motion qui doit etre secondee par un 
autre membre. Le president enonce la 
dite motion a I'assemblee et la discus- 
sion est ouverte, apres quoi il prend le 
vote et annonce le resultat. L'amende- 
ment a une motion est une autre forme 
de procedure par laquelle un membre 
de I'assemblee propose une modification. 
On peut amender la motion par addition, 
iffsertion, elimination ou substitution. 
La technique d'organisation imme- 
diate, en vue de la tenue reguliere 
d'une assemblee, demande de tracer 
un plan determinant la date, I'heure, 
I'endroit, le sujet a etre discute, le 
conferencier a inviter s'il y a lieu. II 
est a propos de rediger un agenda et 
de le faire distribuer aux membres 
quelques jours avant I'assemblee, ainsi 
qu'a ceux qui prendront une part ac- 
tive a la reunion. La publicite est 
assuree par les moyens usuels de la 
presse, de la radio, des annonces au 
prone, des feuillets et des cartes d'in- 
vitation. 

Le nombre et la nature des comites 
different suivant les besoins du ser- 
vice ou de I'organisation. Si un comi- 
te est necessaire, il faut le creer, mais 



un petit nombre de comites travailleurs 
et vivants vaut mieux qu'un grand 
nombre plus ou moins actifs. 

Avant d'approcher le conferencier, 
il est prudent de s'assurer que la date 
de la reunion ne coincide pas avec un 
autre programme interessant la ma- 
jeure partie des gens de la localite. 
Dans une petite ville ce detail est vite 
elimine, mais dans une plus grande 
il est bon de consulter qui de droit 
a ce sujet. 

Le choix du conferencier est aussi 
d'extreme importance. II ne sera ordi- 
nairement pas le meme s'il s'agit d'une 
assemblee ordinaire, speciale ou de 
I'inauguration d'une nouvelle technique 
comme d'un nouveau service. Ouoi- 
qu'il en soit, il doit etre approche a 
I'avance et il est de bon aloi de lui 
offrir un cachet. 

Quelles sont les obligations dues au 
conferencier? D'abord la courtoisie la 
plus raffinee depuis son arrivee dans 
votre localite, jusqu'aux derniers mo- 
ments de son depart, impliquant ainsi 
un maximum de prevenances et 
d'egards. Trop de conferenciers ont 
ete negliges dans le passe et tout ha- 
bitue en la matiere pourrait en relater 
de tristes experiences. Puis des qu'il 
a accepte votre invitation le comite doit 
etre informe des qualifications de ce 
personnage, de son rang social, de la 
fonction qu'il occupe, des services qu'il 
a rendus, selon le cas, pourquoi il est 
invite a parler et le role qu'il aura a 
jouer. Avec ces renseignements il sera 
plus facile, le moment venu et si I'oc- 
casion s'y prete, de converser plus 
librement et intelligemment avec lui. 
Certaines organisations ont meme 
I'initiative de reunir leurs membres 
specifiquement dans le but de faire con- 
naitre leur conferencier. Une photogra- 
phic, par exemple, pourrait aider a le 
faire reconnaitre a premiere vue. 

En lui ecrivant ensuite pour le re- 
mercier. il convient de lui demander 
a quel moment precis il se propose 
d'arriver dans votre localite, quel 
moyen de transport il utilisera. de 
quel materiel il aura besoin, s'il sera 
accompagne, secretaire ou associe, s'il a 
des amis dans la localite qu'il desire in- 
viter, I'informant que ces personnes sont 
bienvenues a I'assemblee et que des 
previsions seront faites a leur egard. 
Quand I'invite aura repondu a toutes 
ces questions le president verra a con- 



150 



THE CANADIAN NURSE 




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FEBRUARY. 1959 • VOL. 55. No. 2 



151 



fier a un membre le devoir d'executer 
les desirs du conferencier, en temps 
opportun. 

Si la seance coincide avec un diner 
ou banquet, le maitre d'hotel sera pre- 
venu assez tot. En lui faisant con- 
naitre le nombre de gens attendus il 
serait sage de lui envoyer I'agenda ou 
programme, cette marque de confiance 
est susceptible parfois de faire bene- 
ficier d'un meilleur service. Un dele- 
gue responsable arrivera sur les lieux 
avant I'heure indiquee et verra aux 
derniers preparatifs de I'evenement. 
S'il y a des billets d'admission ou 
cartes d'invitation a I'assemblee ou au 
diner, et ceci est psychologiquement 
important a plusieurs points de vue, 
on doit s'assurer que le conferencier 
et les invites en sont pourvus. 

Pendant les quelques minutes pre- 
cedant la conference, certains ont I'ha- 
bitude de circuler avec le conferencier 
dans les dififerents groupes. Selon Mr. 
Donahue, expert reconnu en la ma- 
tiere, ce n'est pas une tres bonne poli- 
tique, car le conferencier a besoin de 
toute son energie pour les heures qui 
suivront et il est de mauvaise psycho- 
logic de le faire parader dans une 
assistance qu'il essaiera tout a I'heure 
d'impressionner, une cerlaine distance 
est necessaire a I'etre humain payant 
un ultime hommage a I'inaccessible. II 
est suggere de garder le speaker dans 
une semi-retraite, il ne s'agit pas de le 
releguer a I'ecart, un membre, celui 
qui doit le presenter par exemple, pro- 
fiterait fort bien d'un entretien avec lui. 

Un conferencier a besoin d'une 
bonne presentation autant qu'un livre 
est favorise par une bonne preface. 
La presentation a pour but de creer 
cette ambiance favorable lui permet- 
tant de presenter son message dans les 
meilleures conditions possibles. Elle 
doit reunir trois points et faire savoir 
qui est le confeiencier, quelle est son 
histoire ou son statut et pourquoi il 
est invite. Elle doit etre claire et pre- 
cise, n'excedant pas plus de cinq minu- 
tes. Elle peut etre faite par le presi- 
dent ou toute autre personne assignee 
a cet eflfet. 

Si Ton doit avoir une periode de 
questions et reponses, a la fin de I'as- 
semblee, il est bon d'en discuter a I'a- 



vance avec I'invite, certains d'entre 
eux y excellent, d'autres s'y objectent, 
cette procedure peut donner de grands 
resultats, mais aussi recolter de mal- 
heureux echecs. 

Avant la conference, il est bon aussi 
de prevoir une entrevue avec les jour- 
nalistes ou les messieurs de la radio et, 
s'ils assistent a I'assemblee, un endroit 
leur sera reserve. 

II faut aussi remercier le confe- 
rencier, le president ou le vice-presi- 
dent rempliront cette tache ; souvent 
certaines organisations assignent cette 
fonction a une personne de I'auditoire. 
Meme si le conferencier n'a pas su sou- 
lever tout I'enthousiasme qu'on y at- 
tendait, il a droit a une. certaine 
marque d'appreciation. 

Le lendemain de la conference, le 
secretaire se charge d'ecrire au confe- 
rencier pour le remercier chaleureuse- 
ment. II lui fera parvenir le cachet qui 
lui revient ainsi que les reportages de 
journaux concernant la publicite et la 
critique qu'il a cues. 

Pour assurer aux assemblees tout 
I'eclat et le succes auxquels on aspire, 
il faut mettre beaucoup de dynamisme 
et un certain interet materiel de nature 
a eveiller ou attirer les gens de toutes 
classes et de toutes conditions. II faut 
ton jours se rappeler ce motto emprunte 
au monde theatral : "Put on a good 
show." 

Les gens qui assistaient a une re- 
union le font librement pour y etre 
inspires, amuses ou instruits ; il est im- 
portant de les considerer et de s'adres- 
ser a eux comme individus et non 
comme a une foule, il faut eviter les 
termes trop collectifs. 

Conduire une assemblee est un art 
des plus delicats, et meme arme de 
savantes techniques et de la meilleure 
volonte du monde, il faut tou jours 
s'attendre a un certain montant de cri- 
tique, tout organisateur en sait quei- 
que chose. 

Pour resumer le tout et obtenir un 
denouement heureux, il faut s'assurer 
les services d'un president actif en- 
toure d'un conseil et de membres col- 
laborateurs et productifs. constamment 
stimules par la regularite et la conti- 
nuite des assemblees. 



152 



THE CANADIAN NURSE 




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FKRRIIARY 1959 • VOL. 55. No. 2 



153 



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NURSING 

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PREPARED IN YOUR NATIONAL OFFICE, CANADIAN NURSES' ASSOCIATION, OTTAWA 



Top Priority for Nursing 
Education 

At its December meeting, the Com- 
mittee on Xursing Education proposed 
recommendations which are being pre- 
sented to the Executive Committee at 
ibis month's meeting. These include: 

1. Further study by members in each 
province of the Pilot Project for 
Evaluation of Schools of Nursing. 

2. Fact-finding survey of personnel 
providing instruction in schools of 
nursing ; 

,V Proposed guide for cnrricuhim 
development. 

1. It is hoped that through the type 
of study mentioned above, nurses every- 
where will become more familiar with the 
Pilot Project and all will assist in ex- 
])ressing their beliefs about what is con- 
sidered a desirable school of nursing. Out 
of this study should come valuable sug- 
gestions for the development of Canadian 
criteria for the evaluation of our edu- 

*cational programs. Materials from Na- 
tional Office will form the basis for the 
initiation of such study by the general 
membership. 

2. The survey of teaching personnel 
in schools of nursing will provide infor- 
mation as to (a) the numbers of in- 
structors to the total student body, (h') 
the preparation of each as related to her 
present teaching function. The qualifica- 
tions of those involved in clinical teacii- 
ing, whether considered on the teaching 
staff or not, will also be surveyed. The 
])roposal suggests the survey be con- 
ducted in one specific month in 1959. 
Purpose of this endeavor is to learn how 
well Canadian nursing is fulfilling the 
CNA educational policy.* Suggestions 
for meeting the needs, which may be 
found to exist, have also been outlined. 



.1. Since all provinces rrport interest 
and activity in the realm of curriculum 
development, it was agreed that the 
time is ripe for the preparation of a 
CNA guide for this purpose. This, it is 
felt, would give further expression to 
the CNA statement on policies regarding 
nursing service and nursing education, 
and would be welcome guidance to pro- 
vincial nursing education committees. 
These proposals will be considered 
and \oted upon by the CNA Exectitive 
Committee in session. February 12 — 
14. 1959. 

Interpreters of the Pilot Project 

In line with the thoughts of the 
Committee on Nm^sing Education that 
all CNA members should know about 
the project and its aims, it is fitting to 
stiggest that the regional visitors be 
called upon as interpreters. 

The ele\en visitors appointed from 
various regions to assist the Director in 
evaluating the 25 selected schools have 
now all been involved in at least one 
sur\ev. Since last September. 19 of the 
schools have been sur\'eyed. Each 
evaluator brought to this experience 
a rich backgroimd of knowledge, and 
each expressed tmderstanding of sur- 
vey procedures and the Pilot Project. 

All are well qualified to interpret 
the Pilot Project in their region. It 
is our hope that local chapters and 
other interested grotips will call upon 
them to address meetings, so that a 
greater understanding of the aims of 
the Project may be accomplished. 

The regional visitors are : 
Sister Francoise de Chantal. Sudburv. 



'Policies Regarding Nursing Service and 
Nursing Education — Policy ^4. 



154 



THE CANADIAN NURSE 



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Miss Jeanie S. Clark, Edmonton, Mrs. 
Blanche Duncanson, Toronto, Sister 
Mary Felicitas, Montreal, Miss Doris 
Grieve, Saint John, Sister Mary Kath- 
leen, Toronto, *Sister Leontine Mon- 
grain, Regina, Sister Florence Keegan, 
Montreal, Miss Sheila Nixon, Winnipeg, 
Miss Mary Richmond, Victoria, Miss 
Margaret Street, Calgary. 

Board of Review Pilot Project 

The November issue, in this column, 
carried information concerning the 
meeting of the Board of Review, 
October 22-24. The names of the Board 
Members had not been released at that 
time. It is our pleasure to advise you 
that the board, selected by the Special 
Committee on the Pilot Project and 
approved by the Executive Committee, 
is composed of the following members : 
Mrs. Blanche Duncanson — Toronto 
Miss Elsbeth Geiger — Director of 
Nursing, Phillips Training School, 
Queen Elizabeth Hospital, Montreal. 

Sister Rheault — Hopital St. Jean, 
St. Jean, P.Q. 

Miss Mary Richmond — Director of 
Nursing, Royal Jubilee Hospital, Vic- 
toria, B.C. 

Miss Dorothy Riddell — Senior In- 
spector, Schools of Nursing, Nursing 
Branch, Ontario Department of Health, 
Toronto. 

Miss Glenna Rowsell — Director of 
Nursing Education, St. John's General 
Hospital, St. John's, Nfld. 

Sister Mary Thille — Director of 
Nursing, St. Boniface Hospital, St. 
Boniface, Manitoba. 

Miss Jean Wilson — University of 
Toronto School of Nursing, Toronto, 
Ontario. 

Representing the Canadian Medical 
Association : 

Dr. A. F. W. Peart — Assistant 
Secretary. 

All members were present at the first 
meeting in October, with the exception 
of Sister Rheault. Sister Denise Le- 
febvre attended in her capacity as senior 
bilingual evaluator. 

Mary Richmond was elected chair- 
man of the Board for the duration of 
the Pilot Project and the director, 
Helen Mussallem, secretary. 



(* To evaluate French-language schools 
of nursing.) 



The next meeting of the Board of 
Review has been scheduled for May 
25 to May 30, 1959. 

Nursing at Springhill 

The following information on the 
part nurses played during the Spring- 
hill Disaster was provided upon our 
request, by Mrs. Florence Marney, 

Secretary, Cumberland Co. Branch, 
R.N.A.N.S. We present it here: 

At approximately 8:10 p.m. on October 
23, 1958, Springhill a little town of 
7,000 people in Nova Scotia's Cumber- 
land County, suffered its third disaster 
in two years. An underground upheaval, 
a bump, occurred in number two coal 
mines. 

Once again military, medical, nursing 
personnel and people from all walks of 
life were pressed into service in the 
town. The hospital's regular staff, on 
duty 3 :00 — 11 :00 p.m. was re-enforced 
by the nurses of the town. Nurses also 
were on duty in the Armories which was 
set up as an emergency hospital. During 
Thursday evening Civil Defence officials 
moved in and nursing service then came 
under that group. On Friday six nurses 
from the neighboring town of Amherst, 
N.S., sixteen miles away, were brought 
in on the 7:00 — 3:00 shift and help 
was also given by three nurses from 
Grace Hospital, Halifax. 

After Friday afternoon, the number 
of Springhill nurses available was suf- 
ficient to carry on the nursing service 
alone. It was stated at one time by an 
official that there would be a nurse for 
every patient. This was carried out 
whenever necessary and whenever pos- 
sible. 

Nurses also were called upon at one 
time to assist at the McColl Dressing 
station, located near the mine entrance, 
when the nurse on duty at the First aid 
Station could not handle the work alone. 

There was also a psychiatric unit in 
operation in the town and nurses were 
on duty at all hours, some from the 
Nova Scotia Hospital, Halifax, and some 
local nurses. This service was available 
to any who felt the need of it and 
especially to members of the families 
who had loved ones unaccounted for in 
the mine and to men who had been al- 
ready rescued. 

The nurses on duty, when not busy 
with nursing procedures were well oc- 



156 



THE CANADIAN NURSE 



Make Nursing 

an adventure 

with practical advantages 



As a Nursing Sister with the Royal Canadian Army Medical 
Corps, you get the excitement of adventure and travel . . . 
serving with Canada's Army at home and overseas. 

Opportunities exist to work in the various fields of nursing 
such as teaching and supervision, nursing administration, pub- 
lic health, and operating room techniques and management. 

You receive officer's pay, allowances for uniforms, food and 
accommodation, plus 30 days annual holidays with pay. 

You may apply for a Regular Army appointment for a life- 
time career, or a Short Service Commission whereby you 
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// you are a Registered Nurse, 

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without obligation to: 

Director General of 

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OTTAWA, Ont. 




FEBRUARY, 1959 • VOL. 55. No. 2 



1S7 



cupied easing tensed minds by listening 
to the accounts the men had to tell of 
the "bump" and the horror it produced 
for the individual patients. 

Miss Phyllis Lyttle, Superintendent 
of Nursing, Department of Health, Prov- 
ince of Nova Scotia and representative 
of tlie Provincial Civil Defence Com- 
mittee, was in charge of organizing the 
nursing service generally and was on the 
scene for several davs. At All Saints 



Hospital, Misb R. Hargraves. Super- 
intendent of nurses, was in charge of the 
nursing service and this position at the 
Armories was capably filled by Mrs. G. 
Jones, one of the local nurses. Offers of 
assistance were received from nurse> 
from all over the Maritime provinces. 
It was very heartening for those in 
charge to know that a wealth of nursing 
service was available just for the calling, 
if and when it wa.s needed. 



^e ^Hun^^iK^ ^ t^cuAcn^ Ce fi^cuf^ 



I'leilominance de I'Education en Nursing 

Lors de la reunion du Comite de I'Educa- 
tion en Nursing tenue en decembre dernier. 
les recommandations suivantes ont ete faites 
et seront presentees au Comite Executif an 
rnnrs de ce mois : 

1. Que dans chaque province une etude 

soit faite des objectifs ainsi que des 

nioyens et methodes employes dans 

I'execution du Projet-essai. 
I. Qu'un releve soit fait concernant Ic 

|)ersonnel enseignant dans les ecoles 

d'infirmi^res. 
.V Qu'un projet de guide soit redige 

l)Our Telaboration d'un programme 

d'etudes. 
.Nous esperons que par des etudes dc ce 
genre toutes les infirmieres se famiharise- 
ront avec le prajet-essai d'evaluation des 
ecoles d'infirmieres et qu'elles exprimeront 
icurs idees sur ce qui, dans leur opinion, pent 
etre considere comme une bonne ecole d'in- 
firmieres. Cette etude devrait nous tournir 
de bonnes suggestions qui nous serviront dans 
I'etablissement de criteres pour revaluation 
de nos programmes d'enseignement. Le Se- 
rretariat national fournira la matiere devant 
servir de base a cette etude a laquellc dc- 
\ raient participer tous nos niembres. 

I,e releve concernant le personnel ensei- 
i^nant dans les ecoles d'infirmieres nous ren- 
seigncra sur: (a) Le nombre des institu- 
irices i)ar rapport au nombre total d'etu- 
diantes : (b) la preparation de chacunc. 
ronsiderant les matieres qu'elle doit ensci- 
gner. La preparation des infirmieres chargees 
de I'enseignement clinique, qu'elles f assent 
on non partie du personnel enseignant. sera 
eualement oonnue. II a ete sncreerr- (|iic 



leiKiuete se fasse en 1959, durant un mois 
determine. Le but de cette enquete est de 
savoir si les infirmieres canadiennes suivent 
la ligne de conduite recommandee par I'A.L 
C, en matiere d'education.* Des suggestions 
pouvant permettre de renondre aux besoins 
eventuels ont ete exposees. 

Comme toutes les provinces se montrent 
interessees au developpement et au perfec- 
tionnement du programme d'enseignement, il 
semble que le temps soit venu pour I'A.LC. 
de preparer un guide a cette fin. Nous 
croyons que ce serait la une autre occasion 
d'exprimer la politique de I'A.LC. concer- 
nant I'education et le service d'infirmieres 
et <|ue cela serait bien accueilli par les 
oomites provinciaux d'education. Ces proposi- 
tions seront pre.sentees au Comite Executif 
de I'A.LC. pour etude et approuvees par vote, 
s'il y a lieu, lors de la reunion du 12 fevrior 
1959. 

Bureau de Revision du l^rojet d'Evaltiation 
des Ecoles d'fnfirmieres 

Dans le nnmero de novembre. il etait 
(|uestion, sous cette rubrique, de la reunion 
des membres du Bureau de Revision, tenue 
de 22 au 24 octobre. Le nom des membres 
n'avait pas ete publie alors. II nous fait 
plaisir de vous informer que les membres 
suggeres par le comite special du Projet 
d'Evaluation furent acceptes par le Comite 
Executif et voici leurs noms : 

Mme Blanche Duncanson — Toronto 
Mile Elsbeth Geiger — Directrice (h; 

X'nrsing. Ecole d'Tnfirmiores. Queen Eli- 



*Lignes de conduite concernant le Service 
(i.i Xnrsinc et I'Ednratinn en Xursiii". 



158 



THE CANADI.AN NIRSE 



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FEBRUARY. 1959 • VOL. 55. No. 2 



159 



zabeth Hospital, Montreal. 

Soeur Rheault — Hopital St- Jean, 
St-Jean, P.Q. 

Mile Mary Richmond — Directrice du 
Nursing, Royal Jubilee Hospital, Victo- 
ria, C.B. 

Mile Dorothy Riddell — Visiteuse, 
Ecoles d'Infirmieres, Ministere de la 
Sante de la Province d'Ontario, Toronto. 
Mile Glenna Rowsell — Directrice de 
I'Education en Nursing, St. John's Gen- 
eral Hospital, St-Jean, Terreneuve. 

Soeur Mary Thille — Directrice du 
Nursing, Hopital St-Boniface, St-Boni- 
face, Manitoba. 

Mile Jean Wilson — Ecole d'Infir- 
mieres de rUniversite de Toronto, To- 
ronto, Ont. 

Representant I'Association Medicale 
Canadienne : Le docteur A. F. W. Peart 
— secretaire-adjoint. 

Tous ces membres etaient presents lors de 
la premiere reunion tenue en octobre, sauf 
Soeur Rheault qui fut remplacee par Soeur 
Denise Lefebvre a titre d'evaluatrice con- 
jointe bilingue. 

Mile Mary Richmond fut elue presidente 
du Bureau pour la duree du Projet et Mile 
H. Mussallem, directrice du projet, en sera 
la secretaire. 

La prochaine reunion du Bureau de Revi- 
sion aura lieu du 25 au 30 mai 1959. 

Comment faire connaitre le Projet? 

Le Comite de I'Education en Nursing est 
d'avis que tous les membres de I'A.LC. 
devraient etre mis au courant du projet 
d'evaluation des ecoles d'infirmieres actuelle- 
ment en cours, ainsi que du but de cette 
entreprise. L'on suggere que les visiteuses 
regionales en soient les interpretes. 

Les onze visiteuses regionales nommees 
pour assister la directrice a revaluation des 
25 ecoles choisies a cette fin, ont toutes parti- 
cipe a I'inspection d'au moins une ecole. 
Depuis le mois de septembre 1958, 19 ecoles 
ont ainsi ete visitees. Chaque evaluatrice 
a apporte a I'execution du projet des con- 
naissances approfondies et a parfaitement 
compris le sens de ce travail. Chacune d'elles 
est done en mesure de faire connaitre, dans 
sa region respective, le projet d'evaluation et 
d'en expliquer I'execution et les buts. Nous 
comptons que les Associations de Districts 
et autres groupes interesses inviteront les 
visiteuses regionales a adresser la parole 
lors de leurs reunions et collaboreront ainsi 
a la realisation de I'objectif du projet. 

Les visiteuses regionales sont : 



Soeur Francoise de Chantal, Sudbury, 
Mile Jeanie S. Clark, Edmonton, Mme 
Blanche Duncanson, Toronto, Soeur M. 
Felicitas, Montreal, Mile Doris Grieve, 
Fredericton, N.B., Soeur Mary Kathleen, 
Toronto, Soeur Leontine Mongrain, Re- 
gina, Soeur Florence Keegan, Montreal, 
Mile Sheila Nixon, Winnipeg, Mile 
Mary Richmond, Victoria, Mile Mar- 
garet Street, Calgary. 

Les Infirmieres a Springhill 

Les informations suivantes nous furent 
donnees, a notre demande, par Mme F. 
Marney, secretaire pour le Comite de Cum- 
berland, de I'Association des Infirmieres de 
la Nouvelle-Ecosse. 

Le 23 octobre 1958, Springhill, petite 
ville de 7,000 ames, de la Nouvelle-Ecosse, 
etait le siege d'un desastre. Un soulevement 
souterrain, un choc violent se produisit 
dans la mine de charbon No. 2. 

Une fois de plus Ton fit appel a I'armee, 
aux medecins et aux infirmieres, de meme 
qu'aux personnes de toutes conditions pou- 
vant venir en aide a la ville affligee. Le 
personnel regulier des hopitaux en service 
de 3 a 11 heures fut aide par des infirmieres 
de la ville. D'autres infirmieres furent assi- 
gnees a I'arsenal militaire transforme en 
hopital d'urgence. Le lendemain, le 24 octo- 
bre, la defense civile prit charge des ope- 
rations et la direction du service d'infir- 
mieres. Le vendredi, six infirmieres d'Am- 
herst, ville situee a 16 milles de la, vinrent 
preter main forte a I'equipe de 7 a 3 heures. 
Trois infirmieres du Grace Hospital, Halifax 
offrirent aussi leurs services. 

A compter du vendredi apres-midi, les in- 
firmieres de Springhill purent suffire a la 
tache. II fut declare a un certain moment, par 
une autorite, qu'il y aurait une infirmiere en 
service aupres de chaque blesse. II en fut 
ainsi lorsque la chose s'avera necessaire et 
fut possible. 

Des infirmieres furent aussi demandees 
pour venir aider I'infirmiere chargee de la 
Clinique d'urgence de la mine qui ne pouvait 
suffire a la tache. 

Une clinique psychiatrique fut ouverte dans 
la ville, fonctionnant jour et nuit, et oil il y 
avait aussi des infirmieres dont quelques-unes 
de I'Hopital Nova-Scotia d'Halifax. Les 
services de cette clinique etaient oflferts a 
tous ceux qui avaient besoin de cette aide, 
particulierement aux families eprouvees dont 
un de leurs membres etait encore au fond de 
la mine ou venait d'en etre ramene. 

Les infirmieres en service, lorsqu'elles 



leo 



THE CANADIAN NURSE 



for 

Diaoer 




/isom^ 



I >' B-J 



DIAPARENE 

Clinically proven, effective^ 

• DIAPARENE OINTMENT— medicated, 
soothing ointment to clear up the most obstinate 
case of diaper rash. 

• DIAPARENE POWDER— highly absorbent corn 
starch base, gently medicated, guards against 
prickly heat and chafing. Prevents ammonia 
odour and diaper rash. 

• DIAPARENE RINSE— (tablet or liquid)— added 
to final wash water premedicates diaper 
preventing diaper rash and ammonia odour upon 
contact with urine. 

Most new babies require protection 
against annoying diaper rash. 
-' DIA PA RENE in these three forms assures 
complete prevention and treatment night 
and day. 

DIAPARENE antibacterial preparations for complete baby skin care 

♦Niedelman, M. L. and Bleier, A.; Jour. Ped., 37:5, 762, Nov. 1950 
Fischer, C. C. and Lipschutz, A.; Am. Jour. Dis. Child, 89:5, 596, May 1955 
Benson, R. A., et ah Arch. Ped., 73:250 - 8, July 1956 

DIAPARENE samples and literature available on request to : 

HOMEMAKERS' PRODUCTS (Canada) LIMITED 




36 Caledonia Road 



Toronto 10, Ontario 



FEBRUARY, 1959 • VOL. 55, No. 2 



161 



ii'etaient pas occupees a dunner des soins 
physiques, essaj'aient de diminuer la tension 
nerveuse en ecoutant ce que les escapes 
racontaient de cette terrible experience, 
choc, secousse et horreur terrifiante par la- 
quelle ils avaient passe. 

Mile Phyllis Lyttle, directrice du nursing 
au Ministere de la Sante de la Nouvelle- 
Ecosse et representante du comite provincial 
de la defense civile, etait chargee de I'organi- 
sation generale du service du nursing et 



demeura sur les lieux pendant piusieur? 
jours. 

A I'Hopital All Saints, Mile R. Hargraves, 
directrice des infirmieres, fut chargee du ser- 
vice du nursing et cette meme fonction. au 
manege militaire. etait remplie avec compe- 
tence par Mme G. Jones. 

Toutes les infirmieres des provinces mari- 
times furent unanimes a ofFrir leurs services. 
La pensee que Ton n'avait. au besoin qu'a 
appeler au secours fut tres reconfortante. 



SawdOtSt Beds 



Bf.ulah v. Bourns 



OUR TWO-STORY QUONSET HUT is nOW full 
of patients and our other wards are filled 
as usual. On* of our patients, who was 
brought in off the street, was an 18-year-old 
boy weighing SO lbs. He looked like some 
of my skiraiy little "old men" babies. He is 
now a dififerent boy weighing 75 lbs. We 
just can't fill him up. 

We have a new invention I "Sawdust bed." 
^r treatment and prevention of bedsores in 
paralyzed or aged patients. One man, para- 
lyzed from the waist down, in spite of a 
home-made Stryker frame and every nursing 
care that is possible, had his back break 
out into a huge bedsore 4" wide and 2" deep. 
His heels also were aflfected. Even the pil- 
low used to support his feet caused pressure 
sores. He was ill-nourished and swollen from 
malnutrition. We had to do something about 
it. 

We had heard about sawdust beds and re- 
called reading about them in our nursing 
magazines, so they were worth a try. Then 
came the problem of how to make one. A 



Miss Bourns is at Severance Hospital. 
Seoul, Korea. Her mailing address is 
c/o Canadian Mission, 
190-10, 2 Ka Choong Chung Ro. 
Sudaimoon Ku, Seoul, Korea. 



recovery room bed, also a home-made in- 
vention consisting of a frame to hold a 
stretcher, was utilized with a sheet thrown 
over it to form a pocket for the sawdust. 
Even to find the sawdust was a problem but 
we did find it, spread it out in the sun and 
sifted it. Then with a little prayer we laid 
our patient directly on the sazvdnst. 

To our astonishment, not many days later, 
the dirty wound showed signs of healing. 
Even the skin on his legs looked clearer. 
.\ high protein diet helped his general con- 
dition. In a few weeks this huge hole was 
half the size. We can hardly believe it. 
Now our patient is up in a wheel-chair. We 
are hoping that somehow we will be able to 
buy him a wheel -chair for his own use and 
then he will be able to return home and start 
a new life. 

Sawdust beds are really something. They 
keep the patient always dry, as wood is high- 
ly absorbent ; pine wood has a resin or heal- 
ing oil in it; the- sawdust provides enough 
friction to promote healing and certainly 
makes nursing care easier. Just wash out the 
wound several times a day with soap and 
water, remove damp or lumpy sawdust and 
replace completely every ten days or as 
needed. We now have four patients on saw- 
dust beds and certainlv recommend them. 



The British Royal College of Nursing. 
after working for many years for a shorter 
working week for nursing staffs in hospitals, 
welcomed the approval given by the Ministry 
of Health to the Whitlev Council recommen- 



dation of a 44-hour work week. 

The introduction of these new hours of 
work will call for considerable planning to 
avoid detriment to nursing care of patients 
or sacrincins: the teaching of student nurses. 



162 



THE CA.XADIA.N' NURSE 



,i. 







Advantage of 
Menstrual Tamponage 

confirmed by IS-year study' 

tests involving 5000 women indicate that . . . 

/Unmarried women can use vaginal tampons'*^ 

/Tampons do not cause erosion of the 
cervix, vagina or labia * 

^Tampons do not irritate the vaginal mucosa'-^ 

. y Tampons do not block the menstrual flow'-'* 

y Tampons minimize menstrual odor**^ 

Y Tampons are comfortable . . . help the 

psychological attitude toward menstruation'-^ 



References: 

1. Karnaky, K. J.: Clin. Med. 3:545 

2. Dickinson, R. L.: JI. A.M.A. 128:490 

3. Karnaky, K.J. : West. Jl. Surg., Ob., & Gyn.. 51:150 

4. Thornton, M. J.: Am. Jl. Ob. & Gyn., 46:259 

5. Sackren, H. S.: Clin. Med., 46:327 




for internal menstrual hygiene 



Three absorbencies to meet varying requirements: 
Tampax Super, Tampax Regular, Tampax Junior 

For professional samples and reprints, please write: 



i.^: r^Ci»»-.;^-, 



FEBRUARY. 1959 • VOL. 55. No. 2 



163 



The Registrar 



Ann F. Gavin 



Do we ever think, as the days go by, 

Of one who is striving to keep 

Hundreds of souls contented. 

Or the reward she is sure to reap ? 

The Registrar's duties are arduous. 

When she picks up a telephone, 

Calling a nurse to night duty. 

All she hears is this monotone : 

"Seven to three is the duty I take. 

I never work nights, you know. 

I've given a good many years to this job 

And feel able to choose what I do." 

Ting-a-ling, ting-a-ling, another call goes. 

"Will you take a case for tonight?" 

"Oh dear, no ! If I'm absent at noon 

My husband will not eat a bite. 

Three to eleven are the hours I take. 

If I change those duties you see 

My husband would leave and what would I do 

Without home or husband? Poor me !" 

Over and over, day after day. 

Those self-satisfied savers of lives 

Refuse to respond to emergency calls 

Regardless of who else survives. 

The Registrar, then, so weary of soul, 

Calls on nurses who never refuse 



Who night after night, go weary to work, 

Tho' other hours gladly would choose. 

For they are type who put work before play 

The patient comes first, they believe. 

While the three to eleven, or seven to three. 

If they get what they want, do not grieve. 

Those much pampered nurses, day after day, 

Report to their duties to work. 

No "Golden Rule" ever at night spoils their 

dreams ; 

As their Nightingale pledges they shirk. 

Does it ever, I ask, dawn on them as a sport 

To give the night nurses a break. 

Or help make the Registrar's duty a job. 

With a motto like — well — "Put and take ?" 

Let's give a thought to that friend of the 

nurse 

Who sits by her desk, day by day, 

Trying to keep the machinery at work 

With naught but her salary for pay. 

A kind word or thought would better her 

cause. 

Good team work would help pave the way 

To lighten a task which must sometimes 

grow stale — 

Calling nurses to work night and day. 



Tteiifi^ 'JUtc^ 



ALBERTA 

District 2 



PONOKA 



A bursary is to be presented by the chap- 
ter to a local girl entering nursing in one 
of the province's hospitals. A total of $125 
will be given over the three years in sums 
of $25, $50 and $50. The bursary will be 
available to applicants of schools of nursing 
for September. Mmes Oness, Crowhurst, 
Kinnear, Clapp and Miss Kemp form the 
committee entrusted with setting up the 
award. 

District 4 

Medicine Hat 

Chapter members voted to have a total of 
nine meetings per year omitting the months 



of July, August and December. The January 
meeting was in charge of Miss Helen Clemis 
and was devoted to civil defence. Mrs. 
Batter reported on the official opening of the 
new A. A.R.N, building at a recent meeting. 



District 7 



Vegreville 



Chapter members held a Christmas party 
again in 1958 for children at Mundare 
orphanage. The program included a chil- 
dren's movie at the local theatre with lunch 
served at the nurses' residence afterwards. 
Each child received a gift, a bag of candy 
and fruit and a small toy. The Lions' Club 
provided some financial assistance to make 
the party possible. 

Vermilion 

The executive for the coming year of the 



164 



THE CANADIAN NURSE 



Baby's Own Tablets 

satisfactorily relieved 
every one of 40 babies'^ w^ith 

constipation 

and 34 out of 35 babies'^ with 

teething 

gastrointestinal upset and malaise 

with complete easing of straining Typical Case History 

at stool, gas distress, disturbed 

sleep, restlessness, crankiness and CASE #50. Baby R.S., age 12 

anorexia. months, weight 20 lb. 10 oz., had 

gastrointestinal discomfort and 

REMARKABLY SAFE — "Throughout malaise associated with teething, 

the study ... in no instance was Baby had no teeth as yet, but gums 

there any untoward reaction" what- were tender, puffy and swollen, 

soever. Baby was cranky, irritable, restless 

B A »%#/<-<%...... ■r.R.-r^ ., X,, a"d couldn't sleep. Drooling was 

BABY S OWN TABLETS provide Phe- excessive; appetite poor, 
nolphthalein %6 grain, mildly buf- 
fered with Precipitated Calcium BABY'S OWN TABLETS were given, 
Carbonate Vz grain, and Powdered one each night at bedtime. 
Sugar q.s. Pleasant, convenient. 



♦2 months to 24 months of age. symptoms. Appetite improved. First 

For a sample supply and literature days, then nights, became more corn- 
citing references 1-15 write . . . fortable. Baby now has six teeth. 



G. T. FULFORD CO., LIMITED, Brockville, Ontario 



FEBRUARY. 1959 • VOL. 55, No. 2 165 



local chapter will be : A. Keith, hoii. pres. ; 
Mrs. Z. V. Barr, pres. ; Mrs. M. McLough- 
len, vice-pres. ; Mrs. E. Corley, treas. ; Mrs. 
D. Watt, press ; Mmes D. Coulter, E. Wal- 
(lenberger and Miss J. McPhee, visiting com- 
mittee. The annual Christmas party was 
held with the local doctors and their wives, 
and husbands of the nurses as guests. 

W'.AIXWRK.ll I 

The new executive of the Chanter has been 
elected. The members are: Mrs. E. Mitchell, 
pres.; Mrs. P. Akyroyd, vice-pres.; Miss J. 
Thomas, sec.-treas. The local high school 
girls were invited to attend the opening of 
the nurses' residence. Miss Doris Sundberg 
attended a civil defence course in Edmonton 
and brought back a very interesting report 
of the program presented. She also arranged 
to have two films, "Disaster on Main Street," 
and "Atomic Medical Cases in World War 
11" shown. 

BRITISH COLUMBIA 

Pk\ TKTOX 

Chapter officers have been elected for 
1959. They are : Mrs. L. W. Pigeau, pres. : 
F. Trout, Mrs. V. Crittenden, vice-pres. : 
Mrs. I. Cross, treas. ; Mrs. W. Peters, rec. 
sec. ; Mrs. M. Smith, corr. sec. ; Mrs. D. W. 
Keir, membership ; G. Gow, Mrs. A. Gayfer, 
"Inklings"; M. Banford. program convener: 
Mrs. F. Colclough, publicity; Mmes D. M. 
Deacon, F. Coutts, social committee ; Mrs. 
K. Lucky, sick and visiting convener. The 
annual dance sponsored by the association. 
"White Caps," was held at the end of 
January in the Legion auditorium. 

X'.wcorvi.R 

Si. Paul's Hospital 

The executive of the alumnae association 
entertained the preclinical students at a 
doughnut and coke party recently. Different 
members addressed the students briefly con- 
cerning the association and its work. The 
party was so successful that a decision has 
been made to make it an annual aflfair for 
each new class. 

There were 160 members at the Home- 
coming this year. It was a very pleasant 
event with members of the classes of '25 and 
'26 present as honored guests. Joanne (Slade) 
Cunningham '57 is working at St. Joseph's 
Hospital, Victoria and Irene Field '53 is 
doing public health nursing with a child 
guidance clinic. Irene (Wiest) Witt '46 is 
studying teaching and supervision at U.B.C. 
Marion Boyd who completed her studies in 
public health at McGill last year is pres- 
ently working at Nelson. Shirley Mermet 
'56 is on the staflf of the Kaiser Foundation. 
San Francisco. Edith Fraser '49 is doing 
public health nursing in the city. The De- 
cember meeting of the association was plan- 
ned to coincide with the R.N. A. B.C. Christ- 
mas party which was held at the hospital 
this year. Everyone reported a marvellous 
time. 



MANITOBA 

District 2 



Brandon 



General Hospital 

Mr. H. L. Crawford, associate editor of 
The Brandon Sun, was the guest speaker at 
a recent meeting of the alumnae association. 
He described the moving scenes that marked 
the closing of the British Empire Games at 
Cardiff. Wales and then described the tour 
that took him through England, Scotland 
and four countries on the continent. Colored 
slides brought a glimpse of the World's 
Fair at Brussels to his listeners and took 
them in imagination on a trip down the 
Rhine and through Switzerland. Mr. Craw- 
ford had met well-known Brandonites now 
living abroad and had included pictures of 
them as well to show to their Canadian 
friends. 

It was announced that the nursing service 
and nursing education committees of the 
MARN would hold a refresher course in the 
city in March. The project committee is 
hoping to install a new refrigerator in the 
nurses' residence for the use of the students. 

NEW BRUNSWICK 

MONCTON 

The Christmas meeting of the chapter was 
held at Hotel Dieu L'Assomption with the 
president. Miss Hollenbeck in charge of the 
meeting. A home nursing class is to be con- 
ducted in the hospital during this year. Gifts 
were forwarded to the Provincial Hospital 
in Saint John. The student nu/ses of the 
hospital provided a program of rnost enjoy- 
able entertainment for this meeting. 

Monctoii Hospital 
Nurses' Aid 

The film on "The Treatment of Erythro- 
bastosis Fetalis by Replacement Transfu- 
sion" was shown to members at a recent 
meeting. It proved to be very interesting 
and instructive. A Christmas party took the 
place of the regular meeting in December 
although routine business was transacted. 
Gifts for patients in the provincial mental 
hospitals were placed under the Christmas 
tree at a local store. A gift was presented to 
Mrs. R. Sowerby who is moving away from 
the city. The members sang carols, ex- 
changed gifts and enjoyed a very pleasant 
social time. 

.Saint John 

Miss Edna Shaw shared her experiences 
as a tourist in Europe as well as her very 
interesting collection of colored slides at a 
recent chapter meeting. Miss Shaw spent 
several years in Germany teaching the chil- 
dren of Canadian Air Force personnel. A 
successful bridge party helped to swell associ- 
ation funds. 



166 



THE CANADIAN NURSE 



ONTARIO 



Chatham 



Public General Hospital 

Mrs. A. (Jennings) Longeway was the 
guest speaker at the annual alumnae banquet. 
She gave a most interesting account of the 
International Congress of Nurses held in 
Rome. L. Baird told of her trip to Europe 
at the December meeting. In place ©f the 
usual ex-change of gifts, members contribut- 
ed money to be sent to B. Pardo, a mis- 
sionary in Hong Kong, to use in her work 
with the children there. A bakeless bake sale 
netted a substantial amount of money for the 
Priscilla Cani])beli .Scholarship Fund. 

LoN"IK).\ 

Ontario Hospital 

The alunniae association recently elected 
its new slate of officers. Those members 
holding office are : D. Kerr. hon. pres. : 
Mrs. V. Hey, pres. ; Mmes M. Millen, C. 
Forrestall, Miss N. McDowell, vice-pres. ; 
Mrs. M. Wright, sec. ; Mrs. Chamber, asst. 
sec. ; Mrs. P. Soutar, treas. ; Mrs. E. Gros- 
venor. flower fund ; Miss Padgham, Mmes. 
Hilgert, Bruner, Eraser, program committee ; 
Mmes Griffen. Garner, Guldiken, refresh- 
ments. 

W I \ D.SOR 

Grace Hospital 

A farewell tea was held in honor of senior 
Major Grace Keeling before she left for her 
new appointment in Calgary. The student 
Council held a very successful fashion show 
late last fall. Proceeds were for the stu- 
dents' recreational activities. M. Robson 
'44 presently home on furlough from her 
duties as a missionary in India was tlie guest 
speaker at the January meeting. 

Hotel Dieii Hospital 

riif annual bazaar sponsored by the alum- 
nae association was particularly successful 
this year. There was a net profit of almost 
$500. One of the special highlights of the 
bazaar was the presentation of a gift to Sr. 
Marie de la Eerre (accepted by Sr. Superior 
in Sr. Marie's absence) on the occasion of 
her golden jubilee in the religious order. 
This anniversary has been marked by a 
number of events in the hospital. The De- 
cember meeting was a Christmas party with 
each member bringing a box lunch that was 
eventuallv auctioned, and a small Christmas 
gift. 

C. Meloche '51 is ik)w an intravenous 
therapy nurse at Highland Park General 
Hospital. M. (Harper) Paul '53 is working 
in San Franci.sco. 

Di.^TRur 4 
Ha.mh.'ion 

The annual dinner meeting of the district 
FEBRUARY. 1959 • VOL. 55. No. 2 



In 



MATINEE 

youMl find 
the finest. . . 



p 



> '? « 



c 



^y////^y 




A cigarette of elegance . . . 
A filter of particular purity 



was held late last fall with an attendance 
of 400 members. The guest speaker was Mrs. 
.A. Sengkusch, dean of the School of Nurs- 
ing, University of Buffalo. Her theme was 
"Trends and Outlook in Nursing for the 
Future.'' She stressed the responsibility that 
the professional group has for initiating 
changes, evaluating results and determining 
the value of such changes to nursing. The 
officers elected were : Mrs. Geneva Lewis, 
pres. ; Edith Bingeman, Evelyn Dougler, 
vice-pres.; Mrs. Pat (irant, secretary; Sfrs. 
Esther Cunningham, treas. 

District 6 
Bkllevillf. 
General Hospital 

The tea and bazaar held last fall was a 
tremendous success, tlie total proceeds being 
$548. Miss M. L. Peart planned and directed 
a pageant of nursing that received many 
favorable comments. The annual Christmas 
party was in the form of a potluck supper 
with the members putting 50 cents each into 
a general fund for use by the Salvation 
Army. The hospital chapel was recently 
completed aixl an opening service held. It 
is located in the basement of the building and 
is attractively decorated in blond and green 
with broadloom carpeting and comfortably 
upholstered chairs in harmonizing tones. A 
Hammond organ has also been installed. 

Congratulations are extended to the gradu- 
ating class of 1958 whose members passed all 
registration examinations successfully. The 
school of nursing is also proud to report that 



167 




^<fr- 



Itl feTTiinine Ity^iene arid flaexapy 




An astringent, soothing vaginal douche, thera- 
peutically valuable in the management of infection 
and as a routine cleansing agent. Its refreshing 
odor appeals to the most fastidious patient. 
Available in 3 and 6 oz. jars. Samples on request. 

FORT ERIE, ONTARIO 



facilities for experience in pediatric nursing 
have been expanded to an extent that students 
no longer need to affiliate elsewhere. 

SASKATCHEWAN 

Swift Current 

Chapter members gathered in the main 
lounge of the new nurses' residence in De- 
cember for their first meeting in the room 
that they have furnished for the hospital. 
Mrs. F. Verret presided. A drawing is to be 
held in February as a fund raising project 
since this has proved so successful in former 
years. Mrs. J. Craig was appointed corre- 
sponding secretary — permission having been 
received by the chapter to add this office 
to their executive. Mrs. C. D. Lee report- 
ed on the recent workshop in mental health. 
The film "Girls in White" was shown with 
four collegiate students, prospective nurses, 
as particularly interested observers. The 
girls had an excellent opportunity to find out 
more about the profession as they talked to 



> EfFicien c y 

1^ Ecanomy 

^ Protection 




THAT ALL UNIFORMS 
CLOTHING AND 
OTHER BELONGINGS 
ARE MARKED V/ITH 



CASH'S NAMES 

Permanent, easy idenfificction. Easily sewn on or 

attached with No-So Cement. From dealers or 

CASH'S Belleville 5, Ont. 

CASH'S: 3 Doz. $140; 9 Doz. $3.00; NO-SO 
NAMES: 6 Doz. $2.40; 12 Doz. $3.50; 35< per tube 



their nurse hostesses. Chapter members and 
their guests were taken on a tour of the 
residence at the close of the meeting. 

Union Hospital 

In November, 1958, members of the Board 
proudly welcomed citizens of the district to 
the opening of the new nurses' residence and 
wing of the hospital. The completion of these 
building projects means that the hospital 
now has accommodation for 177 patients and 
78 nurses. Mr. I. Hansen, chairman of the 
Board, greeted the guests at the official 
ceremony while L. E. Plewis, deputy mayor, 
J. Mcintosh, M.L.A. and Everett I. Wood, 
M.L.A. gave brief messages of congratula- 
tion and praise. Reverend J. K. Johnson of 
the local Ministerial Association dedicated 
the building and the ribbon cutting ceremony 
was performed by the Honorable J. Walter 
Erb, Minister of Public Health for Saskat- 
chewan. 

Saskatoon 

St. Paul's Hospital 

Candle-bearing student nurses carolled 
their way through each ward in the hospital 
to the delight of their patients, as part of 
the hospital's Christmas festivities. Twenty 
senior students received their coveted black 
bands in December and were guests of the 
graduate staff at their inservice education- 
al program on the neurosurgical care of a 
patient. The meeting was followed by a social 
hour of music and refreshments. 

Nurses and doctors enjoyed a Christmas 
concert presented by the student nurses and 
featuring carol singing by the Junior and 
Senior Glee Clubs under the direction of 
Miss D. Skinner and Mr. U. Donlevy re- 
spectively ; a piano duet, vocal solo and 
Ukrainian dancing by Class I A ; and the pre- 
sentation of "The Waif" — a Christmas 
story. 



168 



THE CANADIAN NURSE 



Employment Opportunities 

Advertising Rates — $5.00 for 3 lines or less; $1.00 for each additional line. 
U.S.A. & Foreign — $7.50 for 3 lines or less; $1.50 for each additional line. 

Closing date for copy and cancellations : 10th of the month preceding the month of 
publication. All letters should be addressed to : The Canadian Nurse, 1522 Sherbrooke St. W., 
Montreal 25, Quebec. 

Director of Nursing for new 33-bed General Hospital with well equipped surgery wing, in 
new mining town, about 250-mi. east of Port Arthur & northwest of White River, Ontario. 
Starting salary commensurate with experience & qualifications. Apply, stating qualifica- 
tions, experience, age, marital status, etc. to Mr. W. Harrison, Room 1715, 44 King Street 
West, Toronto, Phone EMpire 4-1194, or to the Administrator, Manitouwadge General 
Hospital, Manitouwadge, Ontario, Phone TAylor 6-3251. 

Director of Nursing for 180-bed hospital with a school of nursing. Applicant with University 
Degree &/or postgraduate course preferred. Salary commensurate with experience 6c 
qualifications, position available May 1959. Apply; Secretary, Board of Directors, Victoria 
Union Hospital, Prince Albert, Sask. 

Assistant Director of Nursing Education & Surgical Clinical Instructor for 85-student School 
of Nursing, 200-bed hospital, good personnel policies. Apply Director of Nursing Education, 
St. Michael's Hospital, Lethbridge, Alberta. 

Director of Nursing Education for 500-bed General Hospital with school of nursing. Appli- 
cant must have a degree in nursing. Salary commensurate with experience & qualifica- 
tions. Apply to, Director of Nursing, Royal Jubilee Hospital, Victoria, British Columbia. 

Nursing Supervisor for community owned 18-bed General Hospital. Full maintenance $48 
per mo., in new modern nurses' residence on hospital grounds. Scenic location, in Rocky 
Mountains west of Calgary, Alberta on Trans Canada Highway. For full particulars write: 
C. F. Collins, Secretary, General Hospital, Golden, British Columbia. 

Nursing Supervisor for northern hospital. Good salary, good living conditions. Apply: The 
Matron, Yellowknife District Hospital, Yellowknife, North West Territories. 

Operating Room Supervisor, Operating Room General Duty Nurse for 110-bed modern 
hospital. Excellent personnel policies. Apply: Superintendent, Charlotte County Hospital, 
St. Stephen, New Brunswick. 

Operating Room Supervisor (Immediately) for 86-bed hospital. Good salary, employee 
benefits & statutory holidays, living accommodation available in residence. Locate in Col- 
lingwood & enjoy many winter sports along with excellent skiing in the Blue Mountains. 
Apply, Director of Nursing Services, General & Marine Hospital, Collingwood, Ontario. 

Registered Nurse Supervisors & Staff Nurses (experienced) for outstanding 400-bed hospital 
& home for aged. All shifts (3-11 P.M., 11 P.M. - 7 A.M., 7 A.M. - 3 P.M.) Starting salary $375 
6t $330 per mo. Attractive living quarters available. Good personnel policies. Send com- 
plete resume, Attention: Nursing Director, Menorah Home & Hospital for aged, 871 Bushwick 
Avenue, Brooklyn 21, New York. 

Superintendent of Nurses for Community Hospital, situated 7-mi. from Dawson Creek, B.C. 
Starting salary $300 per mo. with yearly increments of $10 starting after 6-mo. of service. 
28 days annual vacation, 40-hr. wk. Matron's suite available in nurses' residence. Monthly 
maintenance deduction $40. Apply to Administrator, Community Hospital, Pouce Coupe, 
British Columbia. 

Assistant Head Nurses excellent personnel policies. Apply Director, Shriners' Hospital for 
Crippled Children, 1529 Cedar Avenue, Montreal, Quebec. 

Clinical Instructor (Medical Nursing) salary $3,480-$4,440 per annum. 40-hr. week. Apply to, 
Director of Nursing, City Hospital, Saskatoon, Saskatchewan. 

Registered Nurses (3) for Municipal Hospital. Duties to commence January 1, 1959 or as 
soon as possible thereafter. Address correspondence to. The Matron, Municipal Hospital, 
Three Hills, Alberta. 

FEBRUARY, 1959 • VOL. 55, No. 2 169 



Registered Nurses for modern hospital, comfortable home. Starting salary $250 per mo., 

maintenance $35 per mo. Apply: Superintendent, Lome Memorial Medical Nursing Unit, 
Swan Lake, Manitoba. 

Registered Nurses; for 50-bed Hospital, Obstetrical & General Duty. Rotating shifts, 40-hr. 
wk. Apply: Director of Nursing, Ajax & Pickering General Hospital, Ajax, Ontario. 

Registered Nurses for General Duty modern 18-bed Private Hospital in Iron Mining 
town, 180-mi. north of Sault Ste. Marie, Ont. Excellent accommodations & personnel 
policies. Starting salary $255 minimum to $290 maximum for experience, less $20 per mo. 
maintenance. Transportation allowance after 3-mo. service. Apply Superintendent, Miss 
O. Keswick, Lady Dunn Hospital, Jamestown, Ontario. 

Registered Nurses for general duty in all departments — including operating room, pre- 
mature & newborn nursery. Good salary & personnel policies. Apply: Director of Nursing, 
Victoria Hospital, London, Ontario. 

Registered Nurse (1) for September 1959, to take charge of infirmary in a residential 
school, housing approximately 100 boys between 9 & 14 years. Suite of rooms provided 
adjacent to infirmary. Would prefer applicant in early middle age. Apply: Headmaster, 
Ridley College, St. Catharines, Ontario. 

Registered Nurses: Positions available in all areas & on all shifts. Ultra modern, new 
254-bed General Hospital located in the heart of beautiful sunny Castro Valley, just 30 
minutes drive from San Francisco. This is a busy residential community which offers 
casual California living at its very best. Many excellent schools & colleges within easy 
commuting distance. Progressive personnel policies include free hospital & surgical in- 
surance, paid sick leave, paid vacations, 7 recognized holidays & other benefits. No split 
shifts; evening & night duty salary differential, also differential paid for operating room, 
delivery room & nursery service. Uniforms laundered free. Basic salary for general staff 
duty, $320 per mo. Salaries for other positions commensurate with assignments. Please 
write: Personnel Manager, Eden Hospital, 20103 Lake Chabot Road, Castro Valley, Calif. 

Registered Nurses: Are you interested in a starting salary of $355.00 per month? We 
have openings on all services in our new 525-bed Osteopathic Unit scheduled to open 
about April 1. All R.N.s must speak and write English. For full details, write Betty 
Hartwig, R.N., Los Angeles County General Hospital, 1200 North State Street, Los 
Angeles 33, California, We will help you with registration. 

Registered Nurses for new 157-bed General Hospital located in fast growing City of 
Fremont approximately 1-hr. from heart of San Francisco. Good salary, vacation, sick 
leave & hospitalization plan. Contact Director of Nursing Services, Washington Township 
Hospital, P.O. Box 656, Niles, California. 

Registered Nurses: Spend your winter in the Sunny Southwest — New Mexico, "The 
land of Enchantment". Vacancies for staff duty in Medicine, Surgery, Obstetrics, 
Pediatrics, and Operating Room. Salaries $285-$315, days; $10 differential for evenings 
& nights; $15 differential, operating room. No shift rotation. Excellent job benefits. Board 
and room in nurses' residence, $43 per month. Free transportation via 1st Class Air 
travel to Albuquerque and return in exchange for a 1-yr. employment contract. Write 
or call collect Mrs. Margaret Nelson, Director of Nursing, Presbyterian Hospital Center, 
1012 Gold Ave. S.E. Albuquerque, New Mexico. Phone 3-5611. 

Registered Nurses & Certified Nursing Assistants (immediately) for 73-bed General Hos- 
pital on Lake of the Woods. Favorable salaries & personnel policies. Living conditions 
available. Apply Superintendent, Kenora General Hospital, Kenora, Ontario. 

Registered Nurses & Certified Nursing Assistants for new expanding 88-bed hospital in a 
pleasant progressive town. General Duty Registered Nurses start $220, annual increments 
to $240, Certified Nursing Assistants $150, annual increments to $180. 2-wk. shift rotation, 
bonus for 4-12 & 12-8 shifts. Accumulated sick leave to 60-dy. Only 1-hr. drive to Toronto, 
to other cities & resort areas. Local swimming pool, artificial ice arena, bowling, etc. 
Apply: Director of Nursing, Dufferin Area Hospital, Orangeville, Ontario. 

Registered Nurses & Licensed Practical Nurses for new 33-bed General Hospital with well 
equipped surgery wing, in new mining town, about 250-mi. east of Port Arthur & northwest 
of White River, Ontario. Starting salary commensurate with experience & qualifications. 
Apply: stating qualifications, experience, age, marital status, etc. to Mr. W. Harrison, 
Room 1715, 44 King Street West, Toronto, Phone EMpire 4-1194, or to Administrator, Mani- 
touwadge General Hospital, Manitouwadge, Ontario, Phone TAylor 6-3251. 

170 THE CANADIAN NURSE 



Registered Nurse & Licensed Practical Nurse for general floor duty. Gross salary $290 per 
month for R.N., $200 per month for L.P.N, with $25 deducted for full maintenance. 44-hr. 
week. For further particulars please apply to John Hiscock, Secretary-Treasurer, Medical 
Nursing Unit, Baldur, Manitoba. 

Registered Nurses for General Duty Staff. Salary commences at £40-10-0 per mo. with full 
maintenance. Transportation allowance. For full particulars apply Matron, King Edward 
VII Memorial Hospital, Bermuda. 

Registered Nurses for Operating Room with operating room postgraduate courses and/or 
experience, for 140-bed hospital. Travel allowance paid. For particulars, write Matron, 
King Edward VII Memorial Hospital, Bermuda. 

Registered Nurses for General Staff & Operating Room in modern hospital (opened in 1956). 
Situated in the Nickel Capital of the world, pop. 50,000 Salary: $260 per mo. with semi- 
annual merit increments, plus annual bonus plan. Recognition for experience. Excellent 
personnel policies. Assistance with transportation can be arranged. Apply Director of 
Nursing, Memorial Hospital, Sudbury, Ontario. 

Registered Laboratory Technician (Male or Female) will consider recent graduate who has 
not taken the Registry. Good personnel policies; salary open. Write or phone: Administra- 
tor, Sidney A. Sumby Hospital, River Rouge 18, Michigan. 

Surgical Registered Nurses, Staff Registered Nurses for 240-bed General Hospital. 40- 
hr. wk. 15 working days; paid vacation; 7 paid holidays; sick leave. Surgery starting 
base pay $338 stand by & call back time extra. Staff R.N. starting pay $322 monthly; 
regular pay increases; P.M. & night differential $10. Apply: Yolo General Hospital, 
P.O. Box 210, Woodland, California. 

Registered General Duty Nurses (2) Starting salary $260 gross, personnel pxDlicy upon 
request, living in residence. Apply, Matron, Myrnam Municipal Hospital, Myrnam, Alta. 

Registered General Duty Nurses. Salary: $230 per mo. 40-hr. wk. Apply Director of Nursing 
General Hospital, Cobourg, Ontario. 

Registered General Duty Nurses for 118-bed General Hospital along the shores of Lake 
Michigan, 25 mi. from Chicago. Salary: $340 for days, $370 for evenings, $360 for nights 
5 day wk. Good personnel policies. Apply Personnel Director, Highland Park Hospital 
Foundation, 718 Glenview Ave., Highland Park, 111. 

General Duty Registered Nurses for 100-bed General Hospital in town of 6000 on shore 
of Lake Huron. Good personnel policies, 5-day wk., residence accommodation available. 
Please apply to Superintendent, Alexandra Marine & General Hospital, Goderich, Ont. 

General Duty Registered Nurses & Operating Room Nurse (1) for new 56-bed hospital 
on Georgian Bay. Attractive residence. Gross salary $225 per mo. for general duty, 
44-hr. wk. All statutory holidays, 12-dy. sick leave. 3-wk. vacation after 1-yr. Apply to 
Director of Nursing, Meaford General Hospital, Meaford, Ontario. 

Baker Memorial Sanatorium, Calgary, Alberta, offers to Graduate Nurses a 6-mo. post- 
graduate course in Tuberculosis. Salary: $3,480 to $4,080 per annum. Openings also avail- 
able for General Duty Nurses. Residence with board, if desired, $30 per mo. Excellent 
holiday, sick leave & pension benefits. Apply to: Superintendent of Nurses. 

General Duty Nurses for small active hospital. Salary $250 for unregistered. $260 
registered with yearly increments. Nurses' Home available. For further particulars write. 
The Administrator, Lady Minto Hospital, Ashcroft, British Columbia. 

General Duty Nurses for R. W. Large Memorial Hospital United Church of Canada at Bella 
Bella 300-mi., north of Vancouver on B.C. Coast. Transportation refunded after 1-yr., Apply 
to, Matron, R. W. Large Memorial Hospital, Bella Bella, British Columbia. 

General Duty Nurses for modern 35-bed hospital situated on beautiful South Shore. Good 
personnel policies. Excellent living quarters. Apply Superintendent, Fishermen's Memorial 
Hospital, Lunenburg, Nova Scotia. 

General Duty Nurses for an accredited 64-bed hospital. Starting salary: $250-$260. Good 
personnel policies with sick leave benefits holidays & paid vacations. Apply Director of 
Nursing, Douglas Memorial Hospital, Fort Erie, Ontario. 

General Duty Nurses (immediately) for 105-bed General Hospital. Salary $220 per mo. 
with annual increments of $10 per mo., 40-hr. wk., 21 days vacation after 1-yr. 31 days after 
2-yr. Room, board 6. laundry $35 per mo. Apply: Director of Nursing, St. Andrews Hospital, 
Midland, Ontario. 

FEBRUARY, 1959 • VOL. 55, No. 2 171 



McEellar General Hospital, Fort William, Ontario requires General Duty Staff Nurses 

interested in coming to northwestern Ontario. Basic salary, $250 per mo. 40-hr. wk. Good 
personnel policies. Renovation program now complete. Openings in all departments. For 
further information apply to the Director of Nursing. 

General Duty Nurses for modern 42-bed hospital, starting salary, new graduates $255 with 
two (2) yr. experience $270 provided Ontario registration is obtained; these rates to be 
revised October 1st. Ontario registration required for maximum salary. Annual increments, 
6% bonus for evening <S night shifts. 44-hr. wk. with 8 statutory holidays, annual vacation 
21 days first yr. 28-dy. thereafter, monthly sick time allowance. Good living accommoda- 
tions available. Apply to: Nursing Supervisor, Sioux Lookout General Hospital, Sioux 
Lookout, Ontario. 

General Duty Nurses (English speaking) for 466-bed hospital. Nurses' residence available. 
Salary: $315, California registered — $285, Canadian registered. $22.50 differential for 3-11 
& 11-7 shifts. Apply Cedars of Lebanon Hospital, 4833 Fountain Ave., Los Angeles, Calif. 

General Duty Nurses (all shifts) for 140-bed hospital Central California. $310 per mo., plus 
$10 for 3-11 p.m. & 11 p.m.-7 a.m., yearly increases. 5-day wk. paid holidays, paid sick 
leave & vacation plan. Supervisor 3-11 p.m., $351 to start. Operating Room Nurse $325 to 
start. Living quarters on grounds. Write to Director of Nurses, Madera County Hospital, 
Madera, California. 

General Duty Nurses for 600-bed teaching hospital in central California. Inservice educa- 
tional program; 40-hr. wk., 11-hoIidays yearly, retirement & sick leave plan. P.M. & night 
shift differential. $337 per-mo. to start. Write Personnel Director, 732 East Main St., Stockton, 
California. 

General Duty Nurses (California, between Sacramento & San Francisco) for 84-bed 
general short term JCAH hospital. Starting salary $325, nurses' home, excellent working 
conditions. Write, Director of Nurses, Clinic Hospital, Woodland, California. 

General Duty Nurses & Operating Room Nurses for 434-bed hospital; 40-hr. wk. Statutory 
holidays. Salary $250-$312. Credit for past experience & postgraduate training. Annual 
increments; cumulative sick leave; 28 days annual vacation; B.C. registration required. 
Apply Director of Nursing, Royal Columbian Hospital, New Westminster, B.C. 

Attention! General Duty & Surgery Nurses for 400-bed County Hospital located 2-hr. drive 
from San Francisco, ocean beaches, & mountain resorts in modern & progressive city of 
35,000. 40-hr. 5-day wk., 3-wk. paid vacation, 11 paid holidays, paid sick leave, retirement 
plan & social security. Accommodations in Nurses' Home, meals at reasonable rates, 
uniforms laundered without charge. General Duty, $333 mo. start plus shift & service 
differentials. Surgery $382-$460 mo. comp. time if on call. Must be eligible for Calif. Regis- 
tration. Write Director of Nursing, Stanislaus County Hospital, 830 Scenic Drive, Modesto, 
California. 

General Duty Nurses & Certified Nursing Assistants for 86-bed hospital. Living accommo- 
dation available. Collingwood is situated on Georgian Bay & is noted as a vacation land 
in summer with 7-mi. of sand beach, along with great skiing on the Blue Mountains in 
winter. For further information apply Director of Nursing Services, General & Marine 
Hospital, Collingwood, Ontario. 

General Duty Graduate Nurses for an active 76-bed hospital near Calgary & Banff. $250 
gross salary, $260 for Alberta registered, good personnel policy. Apply to Matron, Brooks 
Municipal Hospital, Brooks, Alberta. 

General Duty Graduate Nurses (2). Salary $260 per mo. with annual increments of $10 per 
mo. Room, board & laundry: $40. 28-day vacation after 1-yr. service. All statutory holidays 
paid. Customary sick leave. Graduate complement, 5. Apply giving full details to Matron, 
Slocan Community Hospital, New Denver, B.C. 

Graduate Nurses for 70-bed General Hospital. Salary $260-$280; 5-day wk., 28 days vaca- 
tion plus 10 statutory holidays, after 1 yr. Apply: Matron, St. George's Hospital, Alert Bay. 
British Columbia. 

Graduate Nurses for new 140-bed hospital. 1. Charge nurse for Central Supply, to open 
and organize dept. 2. Head nurse for Pediatric dept. 3. Head nurse for men's Medical 
and Surgical 24-bed dept. 4. Operating Room nurse (1)5. General duty nurses. Positions 
1 to 4 all to have postgraduate courses or equivalent in experience. Salaries and 
personnel policies in accordance with R.N. A. B.C. Positions open August to November 1. 
Apply, Director of Nursing, General Hospital, Chilliwack, British Columbia. 

172 THE CANADIAN NURSE 



Graduate Nurses; for new 63-bed hospital, 30 miles from Vancouver in the Fraser Valley. 
For Salary rates & Personnel policies. Apply: Director of Nursing, Maple Ridge Hospital, 
Haney, British Columbia. 

Graduate Nurses for 37-bed hospital, salary $250 per mo. with annual increments — 28-dy. 
annual vacation, cumulative sick leave — $50 monthly; board, lodging, laundry. New 
50-bed hospital to be erected 1959. Apply: Administrator, Terrace & District Hospital, Box 
1297, Terrace, British Columbia. 

Graduate Nurses for Eastern Townships Hospital. 28 days annual holiday. Complete 
maintenance. Salary commensurate with experience. Apply, E. Decker, Brome-Missis- 
quoi-Perkins Hospital, Sweetsburg, Quebec. 

General Staff Nurses for 400-bed Medical & Surgical Sanatorium, fully approved student 
affiliation & postgraduate program. Full maintenance. Recreational facilities. Vacation 
with pay. Sick benefits after 1 yr. Blue Cross coverage. Attractive salary; 40-hr. wk. For 
further particulars apply Supt. of Nurses, Nova Scotia Sanatorium, Kentville, N.S. 

General Staff Nurses for 300-bed approved hospital & school of nursing. Salary $250 per 
mo. plus $10 & $5 for pm & night differential. Annual increment for 3-yr. 8-hr. day; 
5-day wk; 3-wk. vacation; pension plan; sick time allowance; 8 statutory holidays; 
partial payment of health plan. Apply :Director of Nursing, St. Thomas-Elgin General 
Hospital, St. Thomas, Ontario. 

General Staff Nurses for 370-bed approved General Hospital with intern & resident pro- 
gram. $315 per mo. starting salary. $15 per mo. merit increases at 12, 24 & 36 mo. 40-hr. wk. 
2-wk. paid vacation, paid sick leave, 7 paid holidays. Pleasant coast city in outstanding 
recreational area. Apply Director of Personnel, Seaside Memorial Hospital, Long Beach 13, 
California. 

General Staff Nurses for fully accredited private teaching hospital, located on Lake 

Michigan just north of Chicago. 5-day, 40-hr. wk. Salary range $337.35 to $363.30. Shift 
bonus: $26 afternoons & $17 nights. Progressive personnel policies. Please indicate type of 
service preferred. Apply: Director of Nursing, Evanston Hospital, 2650 Ridge Avenue, 
Evanston, Illinois. 

Staff Nurses (3 immediately) for 18-bed Community Hospital in scenic setting in the heart 
of the Canadian Rockies. Starting salary $250 per mo. Fulll maintenance available in 
modern nurses' residence. For full particulars write: C. F. Collins, Secretary, General Hos- 
pital, Golden, British Columbia. 

Staff Nurses for 250-bed General Hospital, located on the Bay of Quinte; approved School 
of Nursing; planned In-Service education program; desirable personnel policies. For 
further information, Apply to: Director of Nursing, General Hospital, Belleville, Ontario. 

Staff Nurses 600-bed general & tuberculosis teaching institution in central valley City. 
Accredited State & Junior Colleges in immediate vicinity. Liberal personnel policies. 
Salary $320-$360. Full maintenance available. Write — Director of Nursing Service, 
Fresno County General Hospital, Fresno 2, California. 

Staff Nurses for 300-bed General Hospital. Attractive personnel policies plus differentia! 
for specialties, afternoon & night duty. Opportunities for advanced education. Apply to 
Director of Nursing Service, Kai-^er Foundation Hospital, Oakland 11, California. 

Staff Nurses: Relocate to Sacramento, Calif. Sutter Community Hospitals, 440-beds, offer 
$340 per mo. starting salary, $25 per mo. for p.m. & night differential. Tenure salary 
increase plan, 40-hr. wk., Social Security & liberal employee benefit program. Write to 
Personnel Office. 

Pediatric Nurses for 100-bed Pediatric teaching hospital; air conditioned. Good personnel 
policies. Base salary-rotation $290 per mo. Evenings or night $304 per mo. Apply: Director 
of Nursing Service, University of Texas Medical Branch, Galveston, Texas. 

Operating Room Nurse for 106-bed hospital. New hospital & nurses' residence to be com- 
pleted this year. For information regarding duties & salary please write to the Director of 
Nursing, Prince George & District Hospital, Prince George, British Columbia. 

FEBRUARY, 1959 • VOL. 55, No. 2 173 



Operating Room Nurse (P.M.) for 147-bed General Hospital located in a beautiful resi- 
dential surburb along the North Shore of Chicago. Modern ranch style nurses' homes 
with attractively furnished private bedrooms. 40 hr. wk. Salary: $365 for days, $395 for 
evenings. Other employee benefits. Contact the Personnel Director, Highland Park Hospi- 
tal Foundation, Highland Pork, Illinois. 

Public Health Nurse (qualified) for completely generalized program. Salary range, 
pension plan & other personnel policy given on request. Applicant must have car. 
Apply to Dr. Bert Cross, Muskoka District Health Unit, Bracebridge, Ontario. 

Public Health Nurse (Qualified) minimum salary $3,200; allowance for experience. $150 
annual increments; 5-day week; 4wk. vacation; sick leave credits; Blue Cross, pension 
plan, car allowance. Financial assistance towards purchase of car. Apply to Mr. A. F. 
Stewart, Secretary-Treas., Wentworth County Health Unit, Court House, Hamilton, Ontario. 

Public Health Nurses: required in a generalized program in rural & semi-urban area 
adjacent to metropolitan Toronto. Excellent working conditions including pension plan, 
group insurance & transportation arrangements. Write: Dr. R. M. King, York County Health 
Unit, Newmarket, Ontario. 

Chief Dietitian for 140-bed hospital. Training school affiliated with Montreal hospitals. 
Fare paid. For particulars write Matron, King Edward VII Memorial Hospital, Bermuda. 

Dietitian for 90-bed accredited Hospital. Help maintain patients contact; salary open, 
excellent benefits. Write or phone: Administrator, Sidney A. Sumby Hospital, River Rouge 
18, Michigan. 

Metabolic Ward Nurses Experience or interest in nursing techniques on special care 
unit involved in giving special diets, special medicines & insuring accurate collections. 
New state hospital devoted to investigation & treatment of patients with chronic ill- 
nesses requiring active hospital care. Affiliated with medical schools for teaching. Salary 
from $67.25 to $86.75 per wk., based on experience. Liberal sickness & retirement benefits, 
evening & night differential. Rooms available at $9 per mo. & meals at 30 cents each 
Apply Director of Nursing, Lemuel Shattuck Hospital, Boston 30, Massachusetts. 

Night Supervisor & General Duty Nurses for 65-bed JCAH Hospital. Co-Ed College of 1500 
students. Apply Administrator, Berea College Hospital, Inc., Berea, Kentucky. 

Registered Nurse (1) immediately for Margaret Cochenour Memorial Hospital (modern 
15-bed) located on the lake in Red Lake mining district & tourist area. New nurses' 
residence beautifully furnished. Salary: $275 basic with increment plan. Maintenance, 
including uniform laundry, $30 per mo. 44-hr. wk. Holidays. 4-wk. vacation with pay 
yearly. Transportation expense will be paid after 6-mo. employment. Apply, stating age 
6t references to, I. MacNaughton, Matron, Cochenour, Ontario. 

Registered General Duty Nurses (Immediately) for 100-bed Public Hospital in eastern 
Ontario. 44-hr. wk., 2-wk. sick leave, 3-wk. annual vacation. Apply, Superintendent, 
Public Hospital, Smiths Falls, Ontario. 

Registered & Graduate Nurses for General Duty. Apply, Superintendent of Nurses, Mus- 
koka Hospital, Gravenhurst, Ontario. 

Registered Nurse (1). Licensed Practical Nurse (1) as soon as possible for 30-bed hospital. 
Excellent working conditions. 40-hr. wk., overtime pay, living quarters. Salaries $260 <S $195 
per mo. respectively with $5.00 increases every 6-mo. Apply stating age & qualifications to, 
Mrs. R. Maiers, Superintendent, District Hospital, Roblin, Manitoba, or phone 180 collect. 

General Duty Nurse for new active 25-bed hospital in Rocky Mountain vacation land, 
2-hr. drive from Banff. Many recreational facilities. Policies according to RNABC. Full 
maintenance in modern residence, $40 per mo. Apply, Matron, Windermere District 
Hospital, Invermere, British Columbia. 

Staff Nurses for 1 65-bed pediatric teaching hospital. Salary: $315-$348. 40-hr. wk., 6 holi- 
days, 10-day sick leave, vacation. Night or eve. differential, $2.00 per shift. 3-mo. psychiatric 
training required for Mo. registration. Apply to, St. Louis Children's Hospital, 500 So. 
Kingshighway, St. Louis 8, Missouri. 

General Duty Nurses. O.R. Scrub Nurse (For Summer Relief) in modern well equipped 
100-bed General Hospital in a friendly community. Gross Salary $260 per mo. for nurses 
currently registered in Ontario. 8-hr. rotating shifts, 44-hr. wk. 1 day off 1-wk. & 2 the next; 
21 days vacation after 1-yr; 7 legal holidays per yr. Apply: Miss Willamene R. Allan, Reg.N. 
General Hospital, Port Colborne, Ontario. 

174 THE CANADIAN NURSE 



PUBLIC HEALTH NURSES GRADE (1) 

British Columbia Civil Service 

Positions available for qualified Public Health Nurses in various centres in B.C. 

Salary: $290 rising to $345 per mo., car provided. An opportunity for 
interesting & challenging professional service in this beautiful & fast developing 
province. Competition No.: 58:51 1. 

For information & application forms, write 

THE DIRECTOR, 
PUBLIC HEALTH NURSING, DEPT. OF HEALTH, VICTORIA, B.C. or 

THE CHAIRMAN, 
B.C. CIVIL SERVICE COMMISSION, 544 MICHIGAN STREET, VICTORIA, B.C. 



Registered Nurse for Private Boy's Camp duly & August). Use of camp facilities, riding, 
swimming, canoeing etc. Maximum amount of leisure time. Opportunity to assist with camp 
activities. Salary: $150 per mo. plus comfortable accommodation & meals. Apply Rocky 
Mountain Boy's Camp, Invermere P.O. British Columbia. 

Night Supervisor (8:00 p.m.-8:00 a.m.) 4 nights weekly for small Tuberculosis Hospital. 
Write stating age, experience, when available to Director of Nursing, Grace Dart Hospital, 
6085 Sherbrooke Street East, Montreal, Que. 

Superintendent of Nurses (March 1/59) for modern 23-bed hospital, 40-hr. wk. salary range 
$310-$395 per mo., board & room $34.50 per mo. Separate suite in new nurses' residence. 
Excellent train & bus connections with Prince Albert, Saskatoon & Regina. Apply giving 
qualifications to J. L. Fawcett, Sec-Manager, Union Hospital, Rosthern, Saskatchewan. 



REGISTERED NURSES — $3,000-$3,540 
(According to Qualifications) 

SUNNYBROOK HOSPITAL WESTMINSTER HOSPITAL 

TORONTO LONDON 

Employees in both hospitals work a 5-dy. wk. 
Application forms available at your nearest Civil Service Commission Offices, or main Post Office, 
should be forwarded to the CIVIL SERVICE COMMISSION, 25 ST. CLAIR AVENUE EAST, 
TORONTO 7, as soon as possible. 



KEY EXECUTIVE POSITION BEING ESTABLISHED 

With the increased professional activities of the Registered Nurses' Association 
of Ontario a new executive position recently has been created. 

ASSISTANT EXECUTIVE SECRETARY 

Responsibilities will be in administration and RNAO committee work. Salary 
range, related to professional qualifications, is $5,250 — $6,560 per annum. 

Requirements include organization staff experience or administration experi- 
ence in nursing service or nursing education. Degree preparation preferred. 

Applications should include fullest details of academic and work background, 
age, when available. ALL will be treated in strict confidence. 

Write: EXECUTIVE SECRETARY, 

REGISTERED NURSES' ASSOCIATION OF ONTARIO, 
33 PRICE STREET, TORONTO, ONTARIO. 



FEBRUARY, 1959 • VOL. 55, No. 2 175 



EDUCATIONAL DIRECTOR 

FOR SCHOOL OF NURSING 

50-students, 1 -class a year. Good personnel policies. Salary according to 
qualifications. Present Director of Nursing was former Educational Director of 
School. Excellent relationships between hospital administrative staff & nursing 
school. Cornwall "The Hub of the Seaway" is an attractive, progressive city 
on international border easily accessible to Montreal & Ottawa. 

APPLY: 

DIRECTOR OF NURSING, GENERAL HOSPITAL, CORNWALL, ONTARIO 



GRENFELL LABRADOR MEDICAL MISSION 

The Grenfell Mission is now accepting applications for positions in its Hospitals, 
Nursing Stations and Children's Dormitories in northern Newfoundland and 
Labrador. 

Excellent living conditions and splendid opportunities for varied and valuable 
experience. 

For fuW informafion please write: 

MISS DOROTHY A. PLANT, SECRETARY, GRENFELL LABRADOR MEDICAL MISSION 

48 SPARKS STREET, OTTAWA 4, ONTARIO 



APPLICATIONS ARE INVITED BY 

THE BROCKVILLE GENERAL HOSPITAL, BROCKVILLE, ONTARIO 

for the following positions: 

1. Assistant Director, Nursing Education. 

2. Operating Room Supervisor. 

3. Obstetrical Supervisor. 

Postgraduate training is essential and experience in teaching desirable. 

4. General duty nurses for Operating Room also Medical and Surgical 
Departments. 

Salaries Commensurate with preparation and experience. 

For details apply to.- 
DIRECTOR OF NURSING 



GENERAL DUTY NURSES AND 

CERTIFIED NURSING 

ASSISTANTS 

for modern 50-bed hospital in south western 
Ontario. Starting salary. Registered Nurses $240; 
Certified Nursing Assistants $150 with 3 incre- 
ments. 5-day wk., 3-wk. annual vacation, 7 
statutory holidays, accumulative sick time & $15 
shift difFerential. Hospital pays V2 of hospital 
medical plan. 

APPLY: DIRRECTOR OF NURSES 
ALEXANDRA HOSPITAL, INGERSOLL, ONTARIO 



GENERAL DUTY NURSES 

(Graduates) for U.S.A. 

236-bed hospital. 30 miles from New 
York City. Apt. style residence. Good 
salary. Free benefits. Pension plan. 

Apply: 

DIRECTOR OF NURSING, 

MEMORIAL HOSPITAL, MORRISTOWN, 

NEW JERSEY, U.S.A. 



176 



THE CANADIAN NURSE 



SUBURBAN TORONTO 

GRADUATE NURSES & CERTIFIED NURSING ASSISTANTS 

Are invited to enquire re: employment opportunities in a well staffed new 
125 bed hospital in suburban west Toronto. General duty salary range: 
$255-$305 per mo. Certified Nursing Assistants $190-$210 per mo. Residence 
accommodation optional. Personnel manual forwarded on request. Enquire to: 

DIRECTOR OF NURSING, NUMBER MEMORIAL HOSPITAL, 200 CHURCH STREET, WESTON, 
TORONTO 15, ONTARIO — CH 4-5551 



GRADUATE STAFF NURSES — YOU WILL LIKE IT HERE 

Opportunities for men & women on the service of your choice. A 953-bed 
teaching hospital with a friendly atmosphere, well planned orientation program, 
active graduate nurse club, cultural advantages & excellent transportation 
facilities. 

Starting salary: $325 per mo. 6 holidays, sick leave, 3 wk. vacation. 



Director 



For further details write: 
Nursing Service, University Hospitals of Cleveland, Ohio. 



KINGSTON 
GENERAL HOSPITAL 

KINGSTON, ONTARIO 

requires 

Director of Nursing Education (1) 
by July, 1959. Qualifications — 
Bachelor of Science in Nursing 
Degree plus 3-5 years experience. 

IMMEDIATELY 

1. Qualified Clinical Instructresses. 
Maternity (1) and Surgery (2). 

2. General Duty Nurses (1 2) 

3. Certified Nursing Assistants (1 2). 

Salary commensurafe with preparation & 
experience. 

Apply: Director of Nursing 



SARNIA, ONTARIO 

CANADA'S CHEMICAL 
VALLEY 

AND 

PORTAL TO OUR BEAUTIFUL 

BLUEWATER COUNTRY 

You will enjoy being a part of this 
progressive, growing community 
as an employee of the Sarnia 
General Hospital. 

Positions available in all 

services for 

REGISTERED NURSES 

Excellent Personnel Policies include 
40-hour week, 3 weeks paid annual 
vacation, 9 statutory holidays. 

Salary range $2,938 to $3,640 

Please apply to: 

PERSONNEL DIRECTOR 

SARNIA GENERAL HOSPITAL, 

SARNIA, ONTARIO 



FEBRUARY. 1959 • VOL. 55, No. 2 



177 



PSYCHIATRIC NURSING INSTRUCTRESSES 

required by the 
SASK. DEPT. OF PUBLIC HEALTH 

SALARY: $375 per month for those with postgraduate training; $359 

for those without this training. 

REQUIREMENTS: R.P.N, and/or Reg. N., preferably both registrations and 
postgraduate training in nursing teaching and supervision. 
Consideration will be given to those who have registration 
in either field of nursing but who do not have the required 
postgraduate training but are interested in provisional 
appointments pending formal training for which financial 
assistance may be provided. 



DUTIES: 



APPLICATIONS: 



Appointees will serve as instructresses in a three year, 600 
hour training program for student psychiatric nurses. They 
will give lectures, lead seminars and give practical demon- 
strations designed to co-ordinate classroom theory and 
work on the wards. 

Forms and further information available at Public Service 
Commission, Legislative BIdg., Regina. Applicants should 
refer to file number 5706. 



THE WINNIPEG 
GENERAL 
HOSPITAL 

IS RECRUITING 

1. CLINICAL SUPERVISORS 
IN MEDICINE & SURGERY 

2. GENERAL DUTY NURSES 
, FOR ALL SERVICES 

Please send applications direct to: 

THE DIRECTOR OF NURSING, 
THE WINNIPEG GENERAL 

HOSPITAL, 
WINNIPEG 3, MANITOBA. 



SUPERVISOR 

MEDICAL AND SURGICAL 

SUPPLIES 

THE QUEEN ELIZABETH 

HOSPITAL 

TORONTO, ONTARIO 

519-beds, good salary, 40-hr. 
work v/eek, pension, 1-mo. 
vacation & 8 statutory holidays. 

Excellent living accommodation 
if desired. 

APPLY: ADMINISTRATOR 



178 



THE CANADIAN NURSE 




NURSES WHO LIVE 

HERE NEVER STOP 

LEARNING . . . 

GROWING 

. . . THEY WORK AT 

COOK COUNTY 
HOSPITAL 

... in one of the Largest 

Most Stimulating Medical 

Centers in the World 



Residence, Cook County School of Nursing 

Here's an opportunity to gain unique and valuable experience in a public hospital — world's 
largest for acute medical conditions. Cook County Hospital offers you the stimulation of working 
with more than 2,500 other doctors and nurses in one of the world's largest and most exciting 
medical centers. Housing is available at nominal cost. Salaries begin at $340-$372.50 for a 37'/2 
hour week. And you're only minutes from Chicago's fabulous Loop and local universities. 
Graduate NursesI Write today to Director, Cook County School of Nursing, Dept. C, 1900 West 
Polk Street, Chicago 12, Illinois. 



CANADA'S CHEMICAL VALLEY 

SARNIA, ONTARIO 

DIRECTOR OF NURSING SERVICES 

Required for modern, fully approved (JCAH) 300-bed well equipped hospital. 
This progressive industrial city of 45,000 is growing; it is located on the shores 
of Lake Huron and the St. Clair River. 

The hospital has approved schools for nurses, laboratory technologists, x-roy 
technicians, and is approved for intern training. 

Qualifications for applicants include registration in Ontario, at least a 
Bachelor's degree in administration, and successful experience in the field of 
nursing education as well as in administration. 

For more details and literature concerning the position and Sarnia, write to: 

PERSONNEL DIRECTOR 

SARNIA GENERAL HOSPITAL, SARNIA, ONTARIO 



FEBRUARY. 1959 • VOL. 55, No. 2 



1T9 



VICTORIAN ORDER OF NURSES FOR CANADA 

has Staff and Supervisory positions in various parts of Canada. 

Personnel Practices Provide: 

• Opportunity for promotion. 

• Transportation while on duty. 
• Vacation with pay. 

• Retirement annuity benefits. 
For further information write to : 

Director in Chief, 

Victorian Order of Nurses for Canada 

5 Blackburn Ave., Ottawa 2, Ont. 



UNIVERSITY HOSPITAL 

SASKATOON, SASKATCHEWAN 

Requires 
General Staff Nurses for Medical, Surgical, Obstetrical and Pediatric Services. 
Forty hour week. Salary $250 to $290 gross per month. Differential for 
evening and night duty. Residence accommodation if desired. 

Apply to: 

DIRECTOR OF NURSING, UNIVERSITY HOSPITAL, 

SASKATOON, SASKATCHEWAN 



REGISTERED NURSES 

Required by several of the nineteen (19) hospitals in Saskatchewan's 
beautiful Northwest. This area has excellent recreational facilities. 

General Duty Nurses: 40-hr. 5-dy. wk. with generous paid holidays. Excellent 
residence facilities. Salary $260 — $320. 

Superintendent of Nursing: Several required. Wonderful working conditions 
with first class residence facilities. Salary $300 — $385. 

Further information can be obtained, & application submitted to Co-ordinator, 
REGIONAL HOSPITAL COUNCIL, 1165 MAIN STREET, NORTH BATTLEFORD, SASKATCHEWAN. 



WOODSTOCK GENERAL HOSPITAL 

WOODSTOCK, ONTARIO 
REQUIRES INSTRUCTORS FOR 

1. SCIENCE. 2. MEDICAL CLINICAL. 3. SURGICAL CLINICAL. 

4. TEACHING AND SUPERVISION OF CERTIFIED NURSING ASSISTANTS. 

HEAD NURSES — SURGICAL AND MEDICAL 3-1 1 P.M. 
GENERAL STAFF NURSES — EMERGENCY, OPERATING ROOM AND ALL 

DEPARTMENTS. 

GOOD PERSONNEL POLICIES — 5-DAY WEEK. 

For further informafion write: 

DIRECTOR OF NURSING, GENERAL HOSPITAL, WOODSTOCK, ONTARIO. 



180 THE CANADIAN NURSE 



GENERAL DUTY NURSES 

FOR ALL DEPARTMENTS 

Gross salary $255 monthly ($1 17.50 bi-weekly) if registered in Ontario, $235 
monthly ($108.20 bi-weekly) until registered. Annual increment $10 monthly 
($4.60 bi-weekly) for three (3) years. Rotating periods of duty, 40-hr. per wk., 
8 statutory holidays. 1 4-days vacation & 1 2-days leave for illness with pay after 
1-yr. Pension plan available. Ontario Hospital Insurance with Blue Cross 
supplemental & Physicians' Services Incorporated, partial payment by hospital. 

APPLY 
DIRECTOR OF NURSING, GENERAL HOSPITAL, OSHAWA, ONTARIO. 



DIRECTOR -- SCHOOL OF NURSING 

For a school of 90-students, organized independently of Nursing Services. 

The school program follows the pattern of 2-years of nursing education plus 
1-year of internship. 

Requirements: Degree & experience in the administration of a nursing educa- 
tion program. 

Apply to: R. Buckner, Administrator, 

Metropolitan General Hospital, 
Windsor, Ontario. 



THE PETERBOROUGH CIVIC HOSPITAL 

REQUIRES 

NURSES FOR GENERAL DUTY IN ALL SERVICES, INCLUDING 
OPERATING ROOMS & DELIVERY ROOMS. 

For further information write: 

THE DIRECTOR OF NURSING 

PETERBOROUGH CIVIC HOSPITAL, PETERBOROUGH, ONTARIO 



OPERATING ROOM NURSE 

(EXPERIENCED) 
For new 85-bed General Hospital. Situated in a city of 
10,000 population with (2) R.C.A.F. Bases and has 
many recreational facilities. 

APPLY: THE ADMINISTRATOR, 
THE PORTAGE HOSPITAL, DISTRICT 18, PORTAGE LA PRAIRIE, MANITOBA 



FEBRUARY, 1959 • VOL. 55, No. 2 181 



THE PROVINCE 
OF MANITOBA 

requires 

A Number of 

Public Health Nurses 

to work In rural 

Health Units 

Applicants should be nurses registered 
in Manitoba preferably with post- 
graduate training in Public Health 
Nursing or willingness after one year's 
employment to take postgraduate 
training in Public Health. 
Salary schedule with R. N. only 
$3,120-$4,020 per annum. 
With R. N. plus certificate in Public 
Health Nursing $3,480-$4,380 per 
annum. 

Full Civil Service benefits, including 
liberal sick leave with pay, three 
weeks vacation with pay and pension 
privileges. 

Apply stating training, experience and age to: 

THE DIRECTOR, 

PUBLIC HEALTH NURSING SERVICES, 

320 SHERBROOK STREET, WINNIPEG, MAN. 



SARNIA, ONTARIO 

CERTIFIED NURSING 
ASSISTANTS 

As an employee of our modern well 
equipped hospital, you may enjoy 
the excellent opportunities offered 
as resident of this progressive in- 
dustrial city. 

Positions are available In all 
services. 

SALARY RANGE IS FROM 
$2,100 TO $2,508. 

Excellent employee benefits in- 
clude 40-hour, 5-day week. Shift 
differential for evening and night 
shifts. 9 statutory holidays. 

Please apply to: 

PERSONNEL DIRECTOR 

SARNIA GENERAL HOSPITAL, 

SARNIA, ONTARIO 



NURSES REQUIRED 

at 

Roseway Hosp., Shelburne, N.S. 

Superintendent of Nurses — required 
March 1st and immediately 
Assistant Superintendent of Nurses 
General Hospital: General Duty Nurses 
Maternity Nurses 
Nursing Assistants 
Tuberculosis Hospital: General Duty Nurses 
Nursing Assistants 
Additional information may he obtained from 
Miss K. B. Harvey, R.N., Superintendent of Nurses 
Apply to: 
NOVA SCOTIA CIVIL SERVICE COMMISSION 
P.O. BOX 943, HALIFAX, NOVA SCOTIA 
2064 



THE ONTARIO SOCIETY 
FOR CRIPPLED CHILDREN 

92 College St., Toronto 2 

requires 

Experienced Public Health Nurses 

Good salary range & personnel policies 

Apply: 
Supervisor of Nursing Services 



NURSING POSITIONS 
AVAILABLE 

Starting salary $300-$340 per mo; 40-hr. wk., 
4-wk. vacation; 2-wk. sick lime allowance; 
health insurance; living accommodation in 
nurses' residence; evening & night bonus 
$40-$30 per mo.; tuition aid for advanced 
education in nearby universities. 

Lenox Hill Hospital is a large General Hospital 
in the heart of Manhattan, easily accessible to 
the cultural advantages of the large metropolis. 

Write: 

DIRECTOR OF NURSING, 

LENOX HILL HOSPITAL 

76th STREET & PARK AVENUE 

IMIDTOWN NEW YORK) 



DIETITIAN 

(Immediately) 

for 250-bed hospital, with School 
of Nursing. 

Salary commensurate with training 
and experience. 

Apply to: 

Miss Noreen Flanagan, Administrator, 

MUNICIPAL HOSPITAL, MEDICINE HAT, 

ALBERTA 



182 



THE CANADIAN NURSE 



NURSING WITH INDIAN AND 

NORTHERN HEALTH SERVICES 




• HOSPITALS 

* NURSING STATIONS 
A OTHER HEALTH CENTRES 



OPPORTUNITIES 

REGISTERED HOSPITAL NURSES, PUBLIC HEALTH NURSES, 

AND CERTIFIED AUXILIARY NURSES 

for Hospital Positions and Public Health Positions in Outpost Nursing 
Stations, Health Centres and Field Positions in the Provinces, Eastern Arctic 
Northwest Territories and the Yukon Territory. 

SALARIES 

(1) Public Health Nursing Supervisors: up to $5,220 depending upon 
qualifications and location. 

(2) Directors of Nursing in Hospitals: up to $4,950 depending upon 
qualifications and location. 

(3) Public Health Staff Nurses: up to $3,780 per year depending upon 
qualifications and location. 

(4) Hospital Staff Nurses: up to $3,540 per year depending upon 
qualifications and location. 

(5) Certified Nursing Assistants or Licensed Practical Nurses: up to 
$200 per month depending upon qualifications and location. 

• Room, Board and Laundry in residence at reasonable rates. 
Statutory holidays. Three weeks' annual leave v\^ith pay. Generous sick 
leave credits. Hospital-Medical and superannuation plans available. 

* Special pay and leave allowances for those posted to isolated areas. 

For interesting, challenging, satisfying work apply to — Indian and 
Northern Health Services at one of the following addresses: 

(1) Regional Superintendent, 4824 Fraser Street, Vancouver, B.C. 

(2) Regional Superintendent, 1 141 2-1 28th Street, Edmonton, Alberta. 

(3) Regional Superintendent, 735 Motherwell Building, Regino, Saskatchewan. 

(4) Regional Superintendent, 803-9 Confederation Life Building, 457 Main Street, Winnipeg, 
Manitoba. 

(5) Regional Superintendent, 4th Floor, Booth Building, 165 Sparks Street, Ottawa, Ontario. 

(6) Zone Supervisor of Nursing, Box 493, North Bay, Ontario. 

(7) Zone Superintendent of Indian Health Services, P.O. Box 430, Upper Town, 3 Buade Street, 
Quebec 4, P.O. 

or 

Chief, Personnel Division, Department of National Health and Welfare, Ottawa, Ontario. 




FEBRUARY, 1959 • VOL. 55, No. 2 



183 




IFdrmer> 

\Wife 




fNSTANT 

PREPARED 
FORMULA 





\Wife 




INSTANT 

PREPARED 




t 



\ 




"Think we should 
tell our doctor? 




<< 



Certainly! HeMl want to know about the two New 



Farmer's Wife Prepared Formulas with Vitamin C added 1 



t 



Farmer's Wife Infant Formula 
Milks have been consistently 
first in every major infant feeding 
development. Now Farmer's Wife 
is first again, with a stable form 
of Vitamin C (5.0 mg. per fl. oz.) 
in its two new "Instant" 
Prepared Formulas: 

1. Farmer's Wife Red Band Pre- 
pared Formula, made from whole 
milk, with added carbohydrate, and 
Vitamins CandD. {6% Butterfat). 

2. Farmer's Wife Blue Band Pre- 
pared Formula, made from partly 
skimmed milk, with added carbo- 



hydrate, and Vitamins C and D. 
(4% Butterfat). 

These two new Prepared Formu- 
las eliminate the chance of con- 
tamination or error in formula 
preparation. They save mothers 
time, trouble and expense. 

Farmer's Wife is also available in 
the original three strengths — 
Whole Milk, Partly Skimmed 
and Skimmed Milk. 



Farmers 



Prescribed by doctors — 
Approved by mothers 



184 



THE CANADIAN NURSE 




*Calmitol is the non-sensitizing antipruritic supplied as Ointment in 
\yi-oz. tubes and 1-lb jars, and as Liquid, for more stubborn pruritus, in 
2-oz. bottles by Thos. Leeming & Co., Inc., 286 St. Paul St., W., Montreal. 
Write for samples. 



MARCH, 1959 • VOL. 55. No. 3 



185 



INDEX TO ADVERTISERS 



MARCH, 1959 



Abbott Laboratories Ltd 189 

Air Mass, Inc 235 

Bland & Co 197 

Canadian Banana Co. Ltd 249 

Carnation Co. Ltd 253 

Charles E. Frosst & Co 198 

Gerber Products of Canada Ltd. . . 251 

The Good-Lite Mfg. Co 265 

H. J. Heinz Co. of Canada Ltd. . . 227 

Franklin C. Hollister Co 245 

Frank W. Horner Ltd 239 

Johnson & Johnson Ltd 243 

The Kendall Co. (Canada) Ltd. . . 255 

Knox Gelatine 

(Canada) Ltd 236, 237 



Lac-Mac Ltd 266 

J. B. Lippincott Co Cover IV 

Thos. Leeming & Co., Inc 185 

C. V. Mosby Co 263 

Parke Davis & Co. Ltd 231 

J. T. Posey Co 264 

Reitman's Inc 288 

The Ryerson Press 267 

Savage Shoes Ltd Cover III 

Smith KHne & French 259 

Sv^ift Canadian Co. Ltd 257 

VanZant & Co. Ltd 229 

Westwood Pharmaceuticals 261 

White Sister Uniform 

Inc Cover 11 



Subscription Rates: Canada & Bermuda: 6 months $1.75; one year, $3,00; two years. $5.00, 

Student nurses — one year, $2.00 ; three years, $5.00. 

U.S.A. & foreign : one year, $3.50 ; two years, $6.00. 

Single copies 35 cents. 

In combination with the American Journal of Nursing or Nursing Outlook: one year, $8.00 
Make cheques and money orders payable to The Canadian Nurse. 

Change nf address: Four weeks' notice and the old address as well as the new are necessary. 

Not responsible for Journals lost in mail due to errors in address. 

Authorized as Second-Class Mail, Post Office Department, Ottawa. 

Member of Canadian Circulation .Audit Board. 

Advertising Representatives: W. F. L. Edwards & Co., Ltd., 34 King St. E., Toronto 1. Ont. 
Walter Slack, 801 Public Ledger Building, Philadelphia 6, Pa. 

1522 Sherbrooke Street West, Montreal 25, Quebec 



186 



THE CANADIAN Nl>RSE 



THE CANADIAN NURSE 



VOLUME 55 



NUMBER 3 



MARCH 1959 



188 Between Ourselves 

190 New Products 

199 Nursing in New Brunswick Lou O. Smith 

201 Rehabilitation in a Teaching 

Program M. E. Crawford and E. L. Heieren 

20B We Teach — Do our Patients 

Learn? _ Christine Mac Arthur 

21 The Rehabilitation Team M. Lorena McColl 

214 The Story of Johnny Lorraine P. Miller 

216 The Rehabilitation of Mrs. Moritz Dorothy Butler 

21 8 Nursing Care of the Thoracic 

Surgical Patient /. A. Hinson, E. E. Oleksyn, 

C. A. Dafoe 

222 Skin Antisepsis Philip B. Price 

224 The Need for Research in 

Nursing „ Nettie D. Fidler 

228 Une Fructueuse Pratique Sr. Mance Decary 

230 English or French? 

232 Nursing Profiles 

238 In Memoriam 

242 Nursing Across the Nation 

246 Le Nursing a travers le pays 

260 Nursing in Psychiatric Divisions of 

General Hospitals Jean McCrimmon 

2B4 Alberta Certified Nursing Aide Association 

256 Book Reviews 

262 News Notes 

268 Employment Opportunities 

286 Official Directory 



The views expressed 
in the various articles 
are the views of 
the authors and 
do not necessarily 
represent the policy 
or views of 

The Canadian Nurse 
nor of the Canadian 
Nurses' Association. 



Journal Board: Mrs. A. I. MacLeod, chairman, Sr. M. Felicitas. Misses H. Carpenter, R. Chittick, S. Giroux, 

E. Gordon, K. MacLaggan, A. Girard, president CNA; Misses M. P. Stiver, M. E. Kerr. 
editorial Advistrs: Alberta. Miss Irene M. Robertson, 11831-87th Ave., Edmonton; British Columbia, Miss 
Marion E. Macdonnell, 1807 VV. 36th Ave., V^ancouver 13; Manitoba, Miss Sheila L. Nixon, 
Children's Hospital, Winnipeg: New Briinswick, Miss Shirley Y. Alcoe, 180 Charlotte St., 
Fredencton; Newfoundland, Miss Isabel Sutton, 66a Mullock St., St. John's; Nova Scotia, 
Mrs. Hope Mack, P.O. Box 76, Hantsport; Ontario. Miss Jean Watt, R.N.A.O., 33 Price St., 
Toronto; Prince Edward Island, Sr. M. David, Charlottetown Hospital; Quebec, Miss Genevieve 
Lamarre, Hopital de i'Enfant Jesus. Quebec Citv (French). Sr. M. Assumpta, St. Mary's Hospital, 
Montreal (Enghsh) ; Saskatchewan, Miss Victoria Antonini, S.R.N.A., 401 Northern Crown Bldg.. 
Regina. 

Executive Director: Margaret E. Kerr, M.A., R.N. 

Assistant Editors: Jean E. MacC.regor, B.N., R.N.; Gabrielle D. Cote, M.A., R.N. 

Ctrculation Manager: Winnifred MacLean. Production Assistant: Elizabeth M. Hanlon. 

Advertising Assistant: Ruth H. Baumel 

1522 Sherbrooke Street West, Montreal 25, Quebec 



MARCH, 1959 • VOL. 55. No. 3 



187 



^cUuceH Oun4£hi€^ 



Following the presentation by Dr. E. 
Kathleen Russell, of the thought-provoking 
report on the nursing needs of New Bruns- 
wick, things really began to happen. As 
guest editor this month, Lois O. Smith, 
president of the New Brunswick Association 
of Registered Nurses, tells us of the giant 
strides that are being taken by the ambitious 
nurses in this smaller province. 

A native of New Brunswick, Miss Smith 
is supervisor of mental nursing with the 
provincial public health nursing service. 
From her headquarters at the Provincial 
Hospital, Lancaster, she is especially interest- 
ed in smoothing the pathways of patients who 
are being restored to activity in community 
life. A graduate from the McLean Hospital 
School of Nursing, Waverley, Mass., Miss 
Smith enrolled in the University of Toronto 
School of Nursing. She secured her training 
in public health nursing, followed some years 
later by her preparation in administration and 
supervision in public health nursing, with 
special emphasis on mental health work. 

As befits a specialist in mental health. 
Miss Smith has a wide variety of personal 
interests and activities. In addition to her 
considerable responsibilities with the Associ- 
ation, she holds membership in the LO.D.E. 
and the Canadian Club. She plays golf, knits 
and sews, enjoys cooking and a good game 

of bridge and keenly appreciates music. 

* * * 

Last summer a very well organized con- 
ference on Rehabilitation was held in Sas- 
katchewan. American and Canadian profes- 
sional workers gathered in Saskatoon to 
make the International Northern Great 
Plains Conference an outstanding success. 
M. Laurie McColl was responsible for or- 
ganizing the program for the nursing section. 
We are indebted to her persistence in round- 
ing up the papers that were presented at 
this section's session. Several panelists con- 
tributed to the session that has been sum- 
marized under the title "The Rehabilitation 
Team." This group included: Miss Lorraine 
Wright, director of the Training School for 
Nursing Assistants, Saskatoon ; Miss Lor- 
raine Miller, Victorian Order of Nurses ; 
Miss Louise Miner, nursing consultant. De- 
partment of Public Health, Regina ; Sister 
Ann Antoinette, director of nursing educa- 
tion, Notre Dame Hospital, North Battle- 
ford. 



Interest in the development of adequate 
programs of rehabilitation is world-wide. 
Many similar conferences were held in widely 
separated areas. For instance, at almost the 
same time as the Saskatoon conference, a 
Seminar on Rehabilitation of the Disabled 
was held in Indonesia. Forty delegates from 
17 countries in Asia and the far east spent 
a week in discussion. They formulated 18 
conclusions which, if implemented, should 
have a pronounced influence on rehabilitative 
measures in their various countries. It is 
of interest to note in the report of the 
Seminar that the delegates included surgeons, 
social workers, physiotherapists, occupational 
therapists and prosthetic technicians. We 
wonder why there were no nurses — or do 
the social workers fill a dual rule in those 
areas ? 

People who are disabled as the results 
of illness or accidents are as much handi- 
capped by the attitude of society as by their 
physical limitations. The tendency to set 
apart the person who is difTerent because 
of some conspicuous physical problem, is 
being replaced by a realization that the dis- 
abled individual is first a person and only 
secondarily a handicapped one. The new em- 
phasis in the teaching of student nurses 
should encourage a greater public under- 
standing and appreciation of the problems 
created by disabling conditions. 

* * * 

Early last autumn, the School of Nursing 
of the University of Toronto celebrated the 
25th anniversary , of its foundation. As well 
as many social functions, some more formal 
program items were arranged. Among the 
latter was a panel discussion on the impor- 
tance of research in nursing. We are very 
pleased that we are to be privileged to pre- 
sent the papers of the four panelists in 
consecutive issues, beginning with Miss 
Nettie D. Fidler's analysis of the "Need 
for Research in Nursing" in this issue. 

* * * 

.\ milestone in the progress of your 
Journal was reached in January when, for 
the first time, a conference of the newly ap- 
pointed "Editorial Advisers" was held in 
Montreal. Each provincial association was 
represented, with both an English and a 
French language adviser from Quebec. You 
will find the name and address of your prov- 
(Continucd on page 192) 



188 



THE CANADIAN NURSE 




when patients complain of 
itching, scaUng, burning 
scalps — they can be sure 
of quick, lasting control 
when they use 



SELSUN 

for 

seborrheic 

dermatitis 



controls 81-87% of all 
seborrheic dermatitis, 92- 
95% of all dandruff cases. 
Once scaling is controlled, 
Selsun keeps the scalp 
healthy for one to four 
weeks with simple, pleasant 
treatments. Available in 
4-fluidounce bottles 



(Qii^ 



Abbott Laboratories Limited 
Montreal 



® SELSUN Sulfide Suspension / Selenium Sulfide, Abbott 



MARCH. 1959 • VOL. 55. No. 3 



189 



Edited by DEAN F. N. HUGHES 

I'lBLisHED TiiKOUGH CouRTESY OF Canadian Pharmaceutical Journal 

BRONKEPHRINE HYDROCHLORIDE 

Indications — For the relief and management of bronchial asthma, especially in those 
cases which do not respond to other sympathomimetic compounds. 

Administration — Subcutaneously or intramuscularly. 

Adults: Average dose is 1 cc, repeated every 4 hours as needed. 

Children: Dosage varies according to age. Usually 0.5 cc. to 0.8 cc. is sufficient. 

In emergencies may be injected by slow intravenous administration given over a 
period of seven to ten minutes in a dosage of 0.5 cc. 

Description — Each cc. contains ethylnorepinephrine (racemic l-(3,4 dihydroxy- 
phenyl)-2-amino-l-butanol) hydrochloride 2 mg. in an isotonic saline solution with 
sodium acetone bisulfite 0.2% and chlorobutanol 0.25% as preservatives. 

Manufacturer — Carter, Cummings & Co. Ltd., Windsor. 

CALCIUM DISODIUM VERSENATE 

Indications — For reduction of blood and depot lead in (a) lead poisoning — acute 
or chronic; (b) lead encephalopathy; (c) prophylaxis against symptomatic exacerbations 
in chronic lead poisoning. It is worthy of trial in mercury and certain other heavy metal 
poisoning in which it may well be effective. It is of potential value for removal of radio- 
active and nuclear fission products such as plutonium, yttrium. 

Administration — For intravenous infusion only, dissolved in sterile 5% glucose, or in 
solution isotonic sodium chloride and given by intravenous drip. The concentration of 
the drug to be administered should not exceed 3%,. The contents of one ampoule must 
be diluted with at least 33 cc. of diluent. The usual method of administration is as 
follows: Dilute the contents of one 5 cc. ampoule (1 gram) with 250 to 500 cc. of solution 
isotonic sodium chloride or sterile 5% dextrose solution suitable for intravenous injection. 
Administer this diluted solution by intravenous drip over a period of 1 hour. Such 
doses may be administered twice daily for periods up to 5 days. The therapy should 
then be interrupted for 2 days, and, if necessary, followed by an additional 5 days of 
treatment. For children, the dose should not exceed 0.5 gram per 30 pounds of body 
weight, given twice a day. Clinical experience to date does not suggest that larger 
doses per day will prove more effective. However, doses in excess of those presently 
recommended have been given with no untoward effects. Administration of larger 
dosages than recommended should be undertaken with caution. 

Description — 5 cc. ampoules, each containing 1 gram of calcium disodium salt of 
ethylenediamine tetra-acetic acid, for dilution and intravenous infusion. 

Manufacturer — Riker Pharmaceutical Co. Ltd., Cooksville. 

CAPSEBON 

Indications — Seborrheic dermatitis. 

Administration — Wet hair and wash with Capsebon or with a bland soap or deter- 
gent shampoo. Lather, rinse and squeeze out excess water. Work about 1 or 2 tea- 
spoonfuls of Capsebon well into the hair and scalp, adding water if necessary to obtain 
a good lather. Allow lather to remain on scalp and hair for 5 to 10 minutes. Rinse 
thoroughly. 

In severe cases of seborrhea, may be used every other day or twice a week until 
the condition has improved. After this, and with milder cases, a Capsebon shampoo 
once every week or two should suffice. 

Description — A cosmetic, therapeutic shampoo containing 1% cadmium sulfide in 
suspension. 

Manufacturer — E. B. Shuttleworth Limited, Toronto. 



COLCHICINE 

Indications — For the relief of pain in acute gout. 

Administration — Initial dose 1 to 2 tablets followed by 1 tablet every 2 hours. The 
total amount required to relieve the acute attack is usually between 3 and 6 mg. and 
the treatment should not be continued for more than 1 or at the most 2 days. 

Description — Each compressed tablet contains colchicine 0.5 mg. 

Manufacturer — H. Powell Chemical Company Ltd., Bowmanville, Ont. 

HEMROYDINE 

Manufacturer — E. B. Shuttleworth Ltd., Toronto 

Description — Contains: Aluminum acetate, ephedrine HCl, benzocaine, phenol, zinc 
oxide. 

Indications — Reduces swelling and inflammation of hemorrhoids, relieves pain 
promptly. 

Administration — Cleanse parts and apply ointm.ent or insert suppository. 

The Journal presents pharmaceuticals for information. Nurses understand that only a physician may prescribe. 
190 THE CANADIAN NURSE 



McMASTER UNIVERSITY 
School of Nursing 

DEGREE COURSE IN BASIC NURSING (B.Sc.N.) 

A Four-Year Course designed to prepare students for all branches of 
community and hospital nursing practice and leading to the degree, 
Bachelor of Science in Nursing (B.Sc.N.). It includes studies in the human- 
ities, basic sciences and nursing. Bursaries, loans and scholarships are 
available. 

DEGREE COURSE IN SCIENCE TEACHING 
FOR GRADUATE NURSES (B.Ed.N) 

A Two-Year Course designed to prepare graduate nurses to teach basic 
sciences in schools of nursing and leading to the degree, Bachelor of 
Education in Nursing (B.Ed.N.) It includes studies in the humanities, the 
physical, social and biological sciences, teaching and nursing education. 
Bursaries of Six Hur)dred Dollars each are offered in both years of this 
Course. 

For additional information, write to: 

School of Nursing, 
McMaster University, Hamilton, Ontario. 



HYPHEX CAPSULES 

Indications — Microcytic hypochromic anemias, i.e. in pregnancy, malnutrition, anemia 
due to blood loss or infectious disease, achlorhydria, "dumping syndrome," macrocytic 
hyperchromic anemias, i.e. megaloblastic anemia of infancy and pregnancy, nutritional 
anemia, and cases of pernicious anemia where neurological damage is not a problem, 
pre-anemia states due to deficiencies. 

Administration — One capsule twice daily, with or after meals, or as prescribed by 
the physician. 

Description — Each capsule contains: 5 gr. ferrous sulfate, 225 mg. vitamin C, 1 oral 
unit vitamin B12 with intrinsic factor concentrate (non-inhibitory), 10 mcgm. vitamin 
B12, and 2 mg. folic acid. 

Manufacturer — Ayerst, McKenna & Harrison Ltd., Montreal 



KANTREX CAPSULES 

Indications — (1) Preoperative bowel sterilization. (2) Treatment of intestinal infec- 
tions due to kanamycin-susceptible organisms. 

Administration — For oral use only — Preoperative bowel sterilization: 2 capsules 
(1.0 Gm.) every hour for 4 hours; then 2 capsules (1.0 Gm.) every 6 hours for 3 days. 

Intestinal Infections: 2 capsules (1.0 Gm.) to 4 capsules (2.0 Gm.) every 4 to 6 hours, 
tor a minimum of 5 days. Supplementary therapy with Kantrex intramuscular may be 
necessary in systemic infections. 

Description — Kanamycin sulfate, bactericidal antibiotic derived from Streptomyces 
kanatnyceticus. Active against most bacteria present in the intestinal tract, including 
many organisms resistant to other antibiotics. 

Spectrum includes: E. Coli and other coiiiorms A aerogenes, many strains of B. 
protcus, Salmonella Klebsiella pneumoniae, and antibiotic resistant strains of Staphylo- 
coccus aureus and alhiis. 

Active topically, but pcorly absorbed from the gasirointesiinal tract. No significant 
toxicity. 

Manufacturer — Bristol Laboratories of Canada Limited Montreal 

MARCH. 1959 • VOL. 55. No. 3 191 




SCHOOL for GRADUATE NURSES 

McGILL UNIVERSITY 



PROGRAM FOR GRADUATE NURSES LEADING TO THE 
DEGREE OF BACHELOR OF NURSING 

Two-year program for nurses with McGill Senior Matriculation or its equivalent. 
Three-year program for nurses with McGill Junior Matriculation or its equiva- 
lent. In the first year students elect Public Health Nursing or Teaching and 
Supervision in one of the following clinical fields: Medical-Surgical Nursing, 
Psychiatric Nursing, Maternal and Child Health Nursing. 

In the second year students elect to study in one of the following fields: 
Nursing Education, Administration in Hospitals and Schools of Nursing, 
Administration in Public Health Nursing. 

PROGRAM FOR GRADUATE NURSES LEADING TO A DIPLOMA 

Students are granted a diploma on the completion of the first year of the 
degree program. All first-year students elect to study in a particular field as 
stated above. 

PROGRAM IN BASIC NURSING LEADING TO THE DEGREE OF 
BACHELOR OF SCIENCE IN NURSING 

Five-year program for high-school graduates who have passed in the required 
papers of the McGill Junior School Examination or their equivalents. This 
program combines academic and professional courses with supervised nursing 
experience in the McGill teaching hospitals and selected health agencies. 
This broad background of education, followed by graduate professional 
experience, prepares the nurses for advanced levels of service in hospitals 
and community. 

For further information write to: 

DIRECTOR, McGILL SCHOOL FOR GRADUATE NURSES, 
1266 PINE AVE. W., MONTREAL 25, QUEBEC. 



(Continued front page 188) 
ince's editorial adviser page 187. 

As thoroughly as could be done in three 
days of intensive study, these nurses were 
oriented in Journal policies and practices. 
They will be of inestimable assistance to 
us at the Journal office. Moreover, they 
can be of help to you by interpreting your 
wishes for material in the Journal — if you 
pass on your requests to them. 
* * * 

The 100th anniversary of the birth of the 
Red Cross idea will be commemorated in 
1959. 



CHILDREN'S HOSPITAL 
OF WASHINGTON, D. C. 

OFFERS 

Registered Nurses a 16-wk. supple- 
mentary program in pediatric nursing. 
Admission dates, May 6, September 1, 
1959, January 5, May 3, August 30, 
1960. 

For complete information write to.- 

DIRECTOR OF NURSING, 
2125-13fh STREET, N.W., WASHINGTON 9, D.C. 



192 



THE CANADIAN NURSE 



UNIVERSITY OF SASKATCHEWAN 

School of Nursing 




in cooperation with 
UNIVERSITY HOSPITAL 



PROGRAMS FOR GRADUATE NURSES 

Teaching and Supervision 

To meet the needs of nurses wishing to prepare for positions of responsi- 
bility in either teaching or supervision in Schools of Nursing. 

PuUic Health Nursing 

To meet the needs of nurses wishing university preparation for staff work 
in public health nursing agencies. 

Administration of Hospital Nursing Service 

To meet the needs of nurses preparing for head nurse, supervisory ©r 

matron positions. 

This program is supported by the W. K. Kellogg Foundation. 

Diplomas are granted on successful completion of the above programs and 
credits earned may be applied toward the degree of Bachelor of Science in 
Nursing. 

PROGRAMS FOR HIGH SCHOOL GRADUATES 

Leading to the Degree in Nursing 

Students with senior matriculation may pursue a combined academic 
and professional program leading to the degree of Bachelor of Science in 
Nursing. In the final year students will elect to study Teaching and 
Supervision or Public Health Nursing. This broad educational background 
followed by graduate professional experience enables nurses to progress 
rapidly into positions of responsibility. 

Leading to the Diploma in Nursing 

A three year hospital program is conducted for students meeting the 
entrance requirements of the University. 

For further information or inquiries about scholarships, zvritc to: 

DIRECTOR, SCHOOL OF NURSING, UNIVERSITY OF SASKATCHEWAN, 

SASKATOON, SASKATCHEWAN 



MARCH, 1959 • VOL. 55, No. 3 



19t 



UNIVERSITY OF WESTERN ONTARIO 
SCHOOL OF NURSING 

OFFERS THE FOLLOWING PROGRAMS: 

(DA five-year basic program leading to degree, Bachelor of 
Science in Nursing. 

(2) One academic year of study & experience leading to Diploma 
in Public Health Nursing. 

(3) One academic year of study & experience leading to Diploma 
in teaching & supervision in Schools of Nursing. 

(4) One academic year of study & experience leading to Diploma 
in Nursing Service Administration. 

(5) A program for graduate nurses, leading to degree completion. 

For further information write to- 

THE DEAN, SCHOOL OF NURSING, UNIVERSITY OF WESTERN ONTARIO, 

LONDON, ONTARIO 



THE WINNIPEG GENERAL 
HOSPITAL 

Offers to qualified Registered Grad- 
uate Nurses the following oppor- 
tunities for advanced preparation : 

1. A six month Clinical Course in 
Obstetrics. 

2. A six month Clinical Course in 
Operating Room Principles and 
Advanced Practice. 

These courses commence in January 
and September of each year. Main- 
tenance is provided. A reasonable sti- 
pend is given after the first month. 
Enrolment is limited to a maximum of 
six students in each course. 

For further inforfiiation please 
zvrite to: 

DIRECTOR OF NURSING 

GENERAL HOSPITAL 
WINNIPEG, MANITOBA 



THE MOUNTAIN 
SANATORIUM 

HAMILTON, ONTARIO 

TWO-MONTH 

POSTGRADUATE COURSE 

IN THE IMMUNOLOGY, 

PREVENTION & TREATMENT 

OF TUBERCULOSIS 

This course is especially valuable 
to those contemplating Public 
Health, Industrial, or Tuberculo- 
sis Nursing. 

For further information apply to: 

Director of Nursing, 

Mountain Sanatorium 

Hamilton, Ontario. 



194 



THE CANADIAN NURSE 



DALHOUSIE UNIVERSITY 



School of Nursing 

COURSES OFFERED 

1959- 1960 



1 . Degree Course in Basic Professional Nursing 

Candidates for the degree of Bachelor of Nursing are required to complete 
2 years of university work before entering the clinical field, and one year 
of university work following the basic clinical period of 30 months. On 
completion of the course the student receives the Degree of Bachelor of 
Nursing and the Professional Diploma in either Teaching in Schools of 
Nursing or Public Health Nursing. 

2. Degree Course for Graduate Nurses 

Graduate nurses who wish to obtain the degree of Bachelor of Nursing are 
required to complete the three years of university work. 

3. Diploma Courses for Graduate Nurses 

(a) Public Health Nursing 

(b) Teaching in Schools of Nursing 

♦ 

For further information apply to: 

DIRECTOR, SCHOOL OF NURSING 
DALHOUSIE UNIVERSITY, HALIFAX, N.S. 



NOVA SCOTIA SANATORIUM 



KENTVILLE 



N.S. 



Offers to Graduate Nurses a Six- 
Month Course in Tuberculosis Nursing, 
including Immunology, Prevention, 
Medical & Surgical Treatment. 

1. Full series of lectures by Medical 
and Surgical staflf. 

2. Demonstrations and Clinics. 

^. Experience in Thoracic Operating 
Room and Postoperative Unit. 

4. Full maintenance, salary & all staff 
privileges. 

3. Classes start May 1st and Novem- 
ber 1st. 



For information apply to : 

SUPT. OF NURSES, NOVA SCOTIA 
SANATORIUM, KENTVILLE, N.S. 



PSYCHIATRIC COURSE 

for 

REGISTERED NURSES 

The Nova Scotia Hospital offers to 
qualified Registered Nurses a six- 
month certificate course in Psychiatric 

Wursing. 

• Classes in March and September. 

• Remuneration. 

• Preference given to Nova Scotia 
applicants. 

l-'or t'urtlier inturniation api)ly to 

Superintendent of Nurses 
Nova Scotia Hospital 
Drawer 350 
Dartmouth, Nova Scotia 



MARCH. 1959 • VOL 55. No 3 



19S 



THE NATIONAL HOSPITAL 

QUEEN SQUARE 

London, W.C.I 

and 

MAIDA VALE HOSPITAL 

London W.9, England 

(Institute of Neurology, University of 
London) 

Postgraduate Nursing Education for 
Medical Neurology & Brain Surgery 

One year courses are open to Nurses on 
the General Register with good educational 
background. 

3-nio. full time instruction in the school 
under guidance of the Sister Tutor assisted 
by a teaching staff of senior neurologists 
& neuro-supgeons. 

8-mo. clinical experience, 1-mo. vacation. 

Certificate & badge of the hospital av^arded 
to successful students. Staff nurses' salary 
paid throughout the year. This v/ork has a 
special appeal to nurses interested in 
reseorch & the humanitarian aspect of 
nursing. 

For further particulars apply to the Matron, 

THE NATIONAL HOSPITAL 



COURSES 

FOR 

GRADUATE NURSES 

In various clinical fields, 
beginning March 9, June 1, 
August 24, and November 
16, 1959. 

Room, meals, laundering of 
uniforms, and honorarium 
provided. 

Apply to: 

DIRECTOR, 

COOK COUNTY SCHOOL 

OF NURSING, 

DEPT. C, 1900 WEST POLK ST., 

CHICAGO 12, ILLINOIS 



THE JOHNS HOPKINS 
HOSPITAL 

SCHOOL of NURSING 

Offers to qualified Registered Nurses 
a 16- week supplementary course in 

OPERATIVE ASEPTIC TECHNIC 

with instruction and practice in the 
general surgical, neurosurgical, plastic 
orthopedic, gynecologic, ophthalmolo- 
gic, urologic and ear, nose and throat 
operating room services. Maintenance 
and stipend are provided. 

For information ivrite to: 

Director, School of Nursing 

The Johns Hopkins Hospital 

Baltimore 5, Maryland, U.S.A. 



WILLS EYE HOSPITAL 
Philadelphia, Penna. 



The largest eye hospital in the 
United States, offers a six-month 
course in Nursing Care of the Eye to 
Graduates of Accredited Nursing 
Schools. Operating Room Training is 
scheduled in the course. 

• $205 per month for the first four 
months. $215 per month for the last 
two months. 

• REGISTRATION FEE is $20 

• Course starts March 15 & Septem- 
ber 15. Ophthalmic Nurses in great 
demand for hospital eye departments, 
operating rooms & ophthalmologists' 
offices. 



For information ivrite to: 

Director of Nurses, 

Wills Eye Hospital, 

1601 Spring Garden Street, 

Philadelphia 30, Penna. 



196 



THE CANADIAN NURSE 



ROYAL 
VICTORIA 
HOSPITAL 

SCHOOL or NURSING 

MONTREAL, QUEBEC. 

Postgraduate Courses 

1. (a) Six month clinical course in Obstet- 
rical Nursing. 
Classes — September and February. 

(b) Two month clinical course in Gyneco- 
logical Nursing. 

Classes following the six month 
course in Obstetrical Nursing. 

(c) Eight week course in Care of the 
Premature Infant. 



2. Six month course in Operating Room 
Technique and Management. 

Classes — September and March. 



3. Six month course in Theory and Practice 
in Psychiatric Nursing. 
Classes — September and March. 



Complete maintenance or living-out allow 
ance is provided for the full course. 

Salary — a generous allowance for the 
last half of the course. 

Graduate nurses must be registered and in 
good standing in their own Provinces. 

For information and defails of the courses, 
apply to: — 

Miss H. M. Lamont, B.N. 

Director of Nursing, 

Royal Victoria Hospital, 

Montreal, P.Q. 



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MARCH. 1959 • VOL. 55. No. 3 



197 



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TABLETS 

THE ^VONDER COMBINATION OF 

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MEDICALLY PROVEN INGREDIENTS 

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CfvCUde^ 6.c5t066t&Cb. Montreal, Canada 



I9fc THE CANADIAN NURSE 



m mmM mm 

A MONTHLY JOURNAL FOR THE NURSES OF CANADA 
PUBLISHED BY THE CANADIAN NURSES' ASSOCIATION 



VOLUME 55 



NUMBEI 3 



MONTREAL, MARCH 1959 




Irsing in lew Brunswick 



THE New Brunswick Association of 
Registered Nurses is responsible 
for nursing education by an Act of the 
Legislature and, therefore, sets stand- 
ards and makes policies for the schools 
of nursing. For some time, the Asso- 
ciation has been aware that some- 
thing was wrong with nursing and 
ways have been sought to improve the 
schools of nursing and thereby to 
render better nursing service to the 
people of the province. 

Before any action could be taken it 
was necessary to know just where we 
stood in nursing. In order to determine 
this, it was felt that a survey would 
give us a clear picture of what was 
good and what not so good. Having 
come to this decision, the next step 
was to find funds to carry out a survey. 
A brief was presented to the provin- 
cial Department of Health and Social 
Services requesting a sum of money, 
through the federal health grants, for 
the purpose of conducting a survey 
of nursing in New Brunswick. The 
request for funds was granted and the 
study undertaken under the auspices 
of the Dean of Service of the Univer- 



sity of New Brunswick. The survey 
was carried on foi* one year and the 




Lois Smith 



MARCH. 1959 • VOL. 55. No. 3 



199 



report released in the fall of 1956, 
just in time for our annual meeting. 

The report of the survey, now 
known as the Russell Report, has been 
read with interest by nurses and those 
interested in nursing in all parts of 
the world. To us in New Brunswick, 
it has pointed out our weaknesses and 
strengths and the recommendations 
have shown very clearly just what we 
must do. 

Immediately after receiving the re- 
port, a special committee was set up to 
implement the recommendations and 
we are happy to say that we have made 
some progress. Institutes have been 
conducted for clinical instructors, head 
nurses and supervisors as well as work- 
shops and institutes for directors of 
nursing. Besides these, an institute for 
instructors in schools of nursing has 
been held. To carry on these extra ac- 
tivities, it was necessary to increase 
our professional staff by two : one to 
conduct the institutes and the other 
as assistant to the executive secretary. 
Financial assistance for the institutes 
was obtained from the Department of 
Health and Social Services. It was also 
necessary to increase our membership 
fees. 

Another recommendation of the 
Russell Report \\%s that a School of 
Nursing be established at the Univer- 
sity of New Brunswick and this has 
become a reality. With a grant from 
the Kellogg Foundation, this school 
was opened in the fall of 1958 and 
the first students will enter with the 
opening of the Academic year in 1959. 

Another matter which has been 
under consideration for many years 
is the place of the auxiliary nurse 
in organized nursing. The practical 
nurses of the province have requested 
repeatedly that we make provision for 
them under our Act. It was the feeling 



of the Association that such a group 
should be provided for by a public act 
and although we have, on more than 
one occasion, requested that the govern- 
ment make this provision we were told 
that this group belonged to nursing 
and that we should plan accordingly. 
In the spring of 1958, our Act was 
amended giving us power to draw up 
by-laws and regulations for the nurs- 
ing assistant. Since our last annual 
meeting, a special committee has been 
busy preparing such regulations and 
by-laws for presentation at our next 
annual meeting. 

I cannot close these remarks with- 
out mention of our new headquarters. 
In May, 1957, we moved into our new 
home at 231 Saunders Street, Frederic- 
ton, a large, three-story building on 
one-quarter acre of land. Since this 
building is in a residential area, it is 
required that someone on the stafif live 
in the house so, our secretary agreed 
to occupy a part of the building. We 
now have office accommodations, a 
separate apartment for our secretary 
and, just recently, the third floor has 
been made into a beautiful conference 
room. We are very happy to have a 
building of our very own, with ample 
accommodation for our staff and a 
place for all Council, Executive and 
committee meetings. 

These past years have been busy 
and productive but we must go on. 
The survey has shown us what we 
should do and, although we have made 
some progress, we must forge ahead 
with the aim of improved nursing edu- 
cation which will result in better nurs- 
ing service to the people of New 
Brunswick. 

Lois O. Smith, 

President, 

New Brunswick Association of Re- 
gistered Nurses. 



Ill various parts of Canada, poison con- 
trol centres have been set up to supply de- 
tailed information to doctors, hospitals, or 
other interested persons on the poison content 
of many of the commercial substances that 
are often swallowed by children. The anti- 
dote is also supplied by the centre. This 
emergency aid is proving a lifesaver. 

— Dept. of National Health and Welfare 



The Canadian Red Cross and the American 
Red Cross have a mutual agreement to 
supply free blood to tourists who may require 
blood transfusions while visiting in their 
neighboring nation. 

* * * 

The number of those who undergo the fa- 
tigue of judging for themselves is very small 
indeed. — Richard B. Sheridan 



200 



THE CANADIAN NUR.SK 



Rehabilitation in a Teaching Program 



Myrtle E. Crawford and Eleanor L. Heieren 



GREAT interest has been shown in 
methods of teaching rehabilitation 
in the basic nursing program. In order 
to describe how rehabihtation is includ- 
ed in such a teaching program it is 
first necessary to establish what is 
understood by the term "rehabili- 
tation." It can be interpreted in a num- 
ber of different ways. If several nurses 
were asked to define the term one 
would likely be given quite different 
definitions, depending upon the experi- 
ence and philosophy of the nurse who 
was responding. 

This article accepts, in general, a 
definition given in the book, "Fun- 
damentals of Nursing" by Fuerst & 
Wolffi. 

Although rehabilitation has been con- 
cerned particularly with restoring a dis- 
abled person to his best possible health, 
a much broader concept is becoming ac- 
cepted and known today — that rehabili- 
tation is an important aspect of all health 
care. It is not limited to that period of 
time when, for example, a patient may be 
helped with muscle re-education in order 
that he may learn new skills to enable 
him to regain economic and social use- 
fulness. 

Rehabilitation is a continuous process 
and should begin with the earliest contact 
with the ill person. It encompasses physi- 
cal, mental and social elements of care 
and continues throughout the period of 
illness and thereafter until once again 
the patient has become a useful member 
of the community. 

In terms of a more restricted defi- 
nition rehabilitation is a thrilling con- 
cept. In the broader outlook stated 
above it is an intensely challenging 
idea and must be one of the corner- 
stones of professional nursing care. 
The words "professional nursing care" 
bring up a question that is causing 
a great deal of distress in nursing 
circles and one that is giving rise to 

Miss Crawford is a Nursing Arts 
Instructor, Miss Heieren a Surgical 
Clinical Instructor at the University 
of Saskatchewan School of Nursing. 



some serious soul-searching. Can we 
truthfully refer to nursing care as 
"professional" and what do we mean 
by it ? Another question that has caused 
some concern is "Does the nurse really 
have a role in a rehabilitation program 
that cannot be filled by anyone else?" 
It is not the purpose of this discussion 
to go into all the pros and cons of 
these two questions. We raise them 
to have a springboard from which we 
can give an opinion of what makes 
for excellence in nursing care and how 
rehabilitation fits into such a type of 
care. This is fundamental to a consider- 
ation of how rehabilitation may be 
included in a teaching program. 

We believe that certain types of 
nursing can be referred to as pro- 
fessional. To warrant this honorable 
title the broad concept of rehabilitation 
must be included. In other words, 
beginning with her first contact with 
an ill person the nurse has a goal, or a 
series of goals, which are aimed to 
carry the patient through the various 
stages of his illness until he has once 
again become a useful member of the 
community. 

Rehabilitation begins with helping 
the patient to understand his illness 
and to make the necessary emotional 
and physical adjustments to it. It is 
extended to each phase of the personal 
care given to the patient. This care 
must be of such excellence that the 
patient is neither neglected — resulting 
in disability or deformity — nor over- 
whelmed, causing dependence and de- 
terioration of normal capabilities. Im- 
portant in this phase, also, is the ability 
to help the patient to a maximum 
degree of self-care through careful 
guidance and encouragement. A third 
aspect of care is to so plan the teaching 
that the patient will be able to sus- 
tain or maintain the level of health 
and independence that he eventually 
acquires as his maximum state of 
health. There is an important role 
for the nurse in each of these phases 

1. J. B. Lippincott & Co., 1956 



MARCH, 1959 • VOL. 55. No. 3 



201 



of care, for no other member of the 
rehabilitation team can be so helpful 
to the patient in interpretation, in 
personal care and in teaching. 

In teaching nursing arts, major em- 
phasis is given to personal care of 
the patient. This is truly a nursing 
function and the teaching hours are 
weighted so that about one-half the 
total time of the course is spent on this 
aspect. Teaching the student how to 
administer treatments is handled as 
simply as possible. Groups of treat- 
ments — e.g. irrigations — are taught 
as a unit with the emphasis being 
placed on underlying principles rather 
than laborious repetition of steps of 
procedure. This streamlining allows 
time for a few additions that will be 
mentioned later. 

In teaching personal care, much at- 
tention is given to the prevention of 
disease, deformity and disability with 
consideration of poor nursing tech- 
niques that might cause these things 
as well as specific examples of satis- 
factory techniques that should prevent 
them. For instance, in our class on 
decubitus ulcers we emphasize the 
prevention of such ulcers with only 
a small fraction of time being allotted 
to methods of caring for them. We 
spend time considering good posture, 
translating it from the erect position 
to various bed positions, and then dis- 
cuss and demonstrate how this may 
be maintained in bed. Using assistance 
from the Department of Anesthesia, 
protection of the unconscious patient 
is taught. We also discuss ways of 
maintaining good body physiology 
through basic factors such as nutrition, 
exercise and elimination. Throughout 
the course consideration is given to 
emotional and psychological needs of 
the patient. 

It was mentioned earlier that there 
are a few additional topics that are 
included. Two of these are : We ask 
a physiotherapist to demonstrate the 
deep-breathing and leg exercises used 
for surgical patients. The students 
practise these exercises. We also 
arrange for one of the physicians 
from the Department of Rehabilitation 
Medicine to give a few hours of specific 
instructions, dealing especially with the 
meaning of rehabilitation, where it 
fits into the total health picture and 
including also a demonstration of a 



few special techniques used by the 
department. 

The question is frequently asked 
whether there is value in a specialized 
rehabilitation experience for the stu- 
dent nurse — ■ that is, should a period 
of time be spent in a rehabilitation 
department? One may compare the 
value of such experience to that ob- 
tained from operating room experience. 
The average nurse is not going to be 
a specialist in operating room tech- 
nique but she acquires an attitude 
towards surgical aseptic technique that 
is invaluable in such routine proce- 
dures as surgical dressing, catheteriza- 
tion and lumbar puncture. From an 
experience in a rehabilitation depart- 
ment the nurse may learn attitudes to- 
ward improvement in condition and 
recovery, encouragement and team- 
work, consideration of the whole pa- 
tient, as well as special techniques in 
movement and exercise. 

This approach does not constitute 
any revolutionary change in the teach- 
ing of nursing arts, but it is a some- 
what different approach from the strict- 
ly procedure-centered type of teaching 
that was popular ten to fifteen years 
ago. Concurrently with this change 
has developed a greater appreciation 
of what is considered "good" nursing 
care. Compare the typical private nurs- 
ing given to the patient 15 years ago. 
The patient didn't lift a finger for days 
or weeks. The nurse did everything 
for him. 

Beginning with early ambulation in 
surgery and obstetrics we have arriv- 
ed at the kind of care being given today 
in which the nurse must assess the pa- 
tient's strength, understanding, desire 
and readiness to accept responsibility 
for certain aspects of his own care with 
the additional care that he needs still 
being provided. This is actually, a 
much more difficult type of care to 
give, requiring more knowledge, under- 
standing and patience on the part of 
the nurse. The teacher in nursing 
arts has had to adjust her instruction 
to this new form of care. She must 
also be careful to help the student to 
understand that this does not merely 
mean that the patient must do every- 
thing for himself but rather that in 
every situation this process of assess- 
ing and judging the patient's particular 
needs for care, encouragement and 



202 



THE CANADIAN NURSE 



teaching is part of his rehabiHtation. 

At the preliminary student level the 
instructor cannot develop this ability 
to judge in its fullest sense. In fact 
she probably only sees very meagre 
results — but if the seed has been care- 
fully planted she can hope that sub- 
sequent teachers v^'ill nurture and 
develop it. 

What, in general, does rehabilitation 
mean to the clinical instructor who 
functions in general surgery and medi- 
cine? When patients are being taught 
and encouraged to do for themselves 
— no matter how small the tasks may 
be at the beginning — then rehabili- 
tation is in progress. From the defi- 
nition given earlier it should be stress- 
ed that this process must begin early 
and must be continuous and progres- 
sive in order to obtain optimum results. 
We are using a rehabilitation approach 
to nursing when we assist the student 
on the ward to carry out the concepts 
that she has learned in the classroom. 
We help her to develop the understand- 
ing that it is necessary to allow the pa- 
tient to actively participate in such as- 
pects of his care as washing himself 
with assistance, feeding himself with 
assistance, even when the nurse could 
do it more quickly and neatly herself 
and save herself the need for changing 
the patient's linen, etc. We emphasize 
the need to practise such care. 

The patient must of course also 
be convinced that care of this sort 
is good for him and must never be 
made to feel neglected. It is important 
not to confuse this type of nursing with 
the overly busy, shortstaffed ward situ- 
ation where the patient is left to his 
own resources and fends for himself 
or does without. Although this may 
not always be harmful it is certainly 
neither as desirable nor as beneficial 
to the patient as planned independence. 

The rehabilitation approach has been 
used in certain areas for some time. 
We think of a patient in the tuber- 
culosis hospital. He has been taught 
about his disease and the limitations it 
will impose on him. He actively partici- 
pates in his therapy. Attention is paid 
to his general education and to prepa- 
ration for future employment and inde- 
pendence. 

When should rehabilitation start? 
When we set up our nursing care plans 
for the patient do we not assume that 



every patient will recover? Is this not 
where rehabilitation starts? In the 
acute phase of the disease or injury 
the nurse lays the groundwork for 
future rehabilitation by giving ade- 
quate, intelligent care until the patient 
himself is able to participate actively. 
It is also the nurses' responsibility to 
recognize just when it will be advisable 
and beneficial to enlist the patient's 
active participation. 

Any individual who becomes ill is 
a candidate for rehabilitation, regard- 
less of the disease. It may be long- 
or short-term rehabilitation. Many pa- 
tients return to their previous func- 
tional level but others are limited in 
their recovery because of permanent 
disability caused by the disease and not 
because of inadequate or improper care, 
for example, disability following polio- 
myelitis. 

We have long been aware of the 
need to teach the diabetic patient and 
his relatives. We start early to educate 
him about his disease using suitable 
books, pamphlets and explanations. 
Long before discharge we begin his 
education in self-care or if he is not 
able his relative must be taught how 
to look after him. He is taught how to 
test his own urine, to give himself 
insulin under supervision, to under- 
stand the importance of proper diet, to 
give attention to foot care, shoes, 
cautious treatment of abrasions, cuts, 
etc. and to carry a diabetic card as well 
as sugar in some form wherever he 
goes. 

Patients with congestive heart failure 
are taught how to use digitalis and 
what symptoms to watch for — to 
check their pulse and their weight. 
Other examples might include teach- 
ing patients with such conditions as 
phlebitis, an amputation, a gastrectomy 
or a radical mastectomy the important 
factors of their condition so that they 
with the help of their relatives may 
actively participate in the return to 
self-care and to their place again as 
useful members of the community. 

The student has heard much in the 
classroom about the various diseases 
that ha\e been mentioned here. How- 
ever, no matter what her classroom 
background has been, in her early con- 
tact with the ward she is usually too 
busy looking out for herself to give 
much thought to anything except the 



MARCH, 1959 • VOL. 55. No. 3 



203 



procedure she is doing. It is amazing, 
though, to see how quickly she learns 
to associate what she has learned in 
the classroom with the patient situation 
and how soon she begins to apply the 
concepts brought from the classroom. 
Judgment develops slowly and gradual- 
ly. She does need much support and 
guidance in the management of the pa- 
tient's care. This is accomplished 
through direct supervision by the clini- 
cal instructor, head nurse or other 
nursing staff. Ward conferences, clinics, 
nursing care plans outlined on the 
Kardex, the example set by the nurs- 
ing service personnel, all contribute 
to her learning. 

Our concept of good nursing care 
has changed much in recent years. 
One explanation of this change is the 
increase in patients using prepaid 
hospital plans. There are now fewer 



private patients paying directly for 
their own care. The special duty nurse 
who accepts remuneration directly from 
the patient for the service given has 
more difficulty managing the patient's 
care than the general staff nurse who 
accepts her salary from the hospital. 
So, in a sense, are hospitals also freed 
by the use of prepaid hospitalization. 
The emphasis is more on what is best 
for the patient and not necessarily what 
the patient wants or can afford. 

It is a truism that when we are 
well we don't always want that which 
is best for our state of health. Thus we 
must be understanding with the patient 
who finds it difficult to cooperate. We 
must be patient, use gentle firmness, 
have controlled sympathy for the pa- 
tient's predicament, be ready to stand 
by and encourage him and rejoice over 
what to us may seem to be a very 
small accomplishment. 



In the Good Old Days 

(The Canadian Nurse — March, 1919) 



Speaking to the members of an alumnae 
association, a Toronto doctor strongly urged 
them to undertake the foundation of a society 
devoted to preventing blindness in children 
from venereal disease. He advocated compul- 
sory treatment of the eyes of all newborn 
babies, fines for parents who tried to pre- 
vent- it and permanent recording on the 
child's birth certificate of the measures taken 
to protect the eyesight at birth. 

* * * 

The Ontario legislature introduced a law 
requiring the physician to treat the eyes 
of the newborn with one per cent silver ni- 
trate or 40 per cent argyrol. Cases of in- 
fected eyes in babies up to two weeks were 
to be reported to the local medical Office 
of Health. 

* * * 

About 53,000 pupils are found annually 
with dental defects (in Toronto). The regis- 
tered attendance of the public schools is 
about 64,000 and that of the separate (pa- 
rochial) schools about 8000. 

* * * 

There can be no argument against the 
eight-hour day if it can be arranged to give 



as good service to the patient as with the 
longer day, and, at the same time, avoid a 
large expense to the hospital in a greatly 
increased staff of nurses. 

* * * 

The question of how much sleep is neces- 
sary for the health of human beings has for 
long been of interest to scientists ... A 
number of scientific men some time ago 
agreed to be forcibly kept awake for ninety 
hours. Only three "victims" were able to 
endure to the end; but, curiously enough, 
it was discovered that all three maintained 
a steady increase in weight during their 

time of trial. 

* * * 

-An article in the British Medical Journal 
denounced the practice of immobilizing in- 
jured limbs . . . Splints should not be used 
unless absolutely necessary, and then for as 
short a time as possible. Frequent passive 
and active movements should be carried out, 
steadily increasing the range. 

* * * 

A concentrated solution of Epsom salts 
was recommended for the treatment of burns 
and scalds. 



204 



THE CANADIAN NURSE 



We Teach - Do our Patients Learn? 



Christine MacArtiur, B.S. 



THE TITLE of this article contains 
the most important philosophy of 
the principles of rehabilitation : the 
essence of rehabilitation is good teach- 
ing. 

Why do so many of us assume that 
teaching is synonymous with telling? 
Our goals in teaching patients are : 
to impart information ; then to moti- 
vate the patient to a particular ac- 
tion as a result of that information. 
First, we must find out what the pa- 
tient knows. This can only be done 
by effective questioning. Merely to 
tell a patient some facts that we have 
stored up is easy. To ask significant 
questions requires thinking and time. 
Learning is more a self-discovery than 
being told something. 

One reason why we as nurses tend 
to avoid the question approach is that 
one question invites another and we 
are afraid we may find ourselves in 
deep water. If we merely tell what we 
know we feel safe. This is particularly 
true of inexperienced nurses as for 
instance, those who have just complet- 
ed their public health nursing course. 
They are filled to the brim with the 
theory they have been acquiring all 
year and they can hardly wait to un- 
load it on every patient with whom 
they come in contact. 

However, just asking questions isn't 
enough. We must ask significant ques- 
tions. If the question leads the patient 
to tell what he knows or how he feels 
it will make him think and his interest 
is aroused. His answer will also give 
the nurse some idea of his attitudes. 
For example, the question, "How are 
you going to manage brushing your 
teeth ?" makes the patient think through 
the process step by step. If the nurse 
merely tells him how or said "Do you 
know how" the patient is not required 
to think for himself. 

How many times have we said "I've 
told him and told him !" The patient 

Miss Mac.\rthur is Educational Di- 
rector with the National Office of the 
Victorian Order of Nurses for Canada, 
Ottawa. 



can be told a hundred times but if 
he has not been motivated it is to no 
avail. In public health nursing we have 
stressed that nurses be good li.^teners 
but before anyone can be a good lis- 
tener she must be a good questioner. 
Teaching is more than telling — it 
must be planned. It must be adapted 
to each individual's needs. 

To be a good teacher in rehabili- 
tation and to ask significant questions, 
we need to have a broad knowledge of 
the newer skills and techniques of reha- 
bilitation. It may mean a stock-taking 
of the nurse's own attitudes. To do 
for a patient is almost a conditioned 
reflex with some nurses, who derive 
a great deal of satisfaction in being 
needed and in rendering a ser\ ice 
which they know how to give well. 
To give up some of this satisfaction in 
favor of guiding a patient through slow, 
fumbling, half-hearted efforts to do 
something for himself is both tr\ing 
and fatiguing. The nurse needs to be 
very secure in her skill in rehabilitation 
nursing to derive the same satisfaction 
and sense of accomplishment from her 
new role. 

What does rehabilitation nursing 
mean? The word rehabilitation has 
become almost a by-word in present 
day society and there are many dif- 
ferent interpretations depending on the 
interest of the individual defining it. 
Rehabilitation is really as old as civili- 
zation. The Bible merely said " Heal 
the sick." Victorian Order nurses for 
over 60 years have been helping sick 
and disabled people maintain and re- 
gain their health and usefulness. 

In terms of V.O.N. 'care we think 
of rehabilitation as just good nursing 
care from the first day of illness until 
the patient completely recovers. Some- 
times complete recovery is not possible 
and in these instances patients are 
assisted to live as happily and inde- 
pendently as possible. 

Over half the branches in the \^ic- 
torian Order of Nurses are in small 
communities where the nurse for the 
most part is working alone with the 
doctor and familv. The nurses have 



MARCH, 1959 • VOL. 55. No. 3 



205 



always given iheir patients the best 
nursing care possible, or the best with- 
in their knowledge. However, in the 
past decade medical and nursing 
sciences have advanced tremendously 
and we have learned new ways to help 
patients back to health. This newer 
knowledge has been particularly ap- 
plicable to patients with long-term or 
chronic illnesses, such as, arthritis, 
hemiplegia, heart conditions, fractures, 
diseases of the nervous system. Until 
recently many of these conditions re- 
sulted in crippling and a dependency 
on others which might have been 
prevented had this newer knowledge 
been available. 

Since the Second World War there 
has been an increased emphasis on 
rehabilitation due in part to the large 
number of disabled veterans requiring 
care. Victorian Order nurses were con- 
cerned because of the increasing num- 
ber of patients with long-term ill- 
nesses who were being referred for 
care. Many of them seemed hopeless 
invalids, confined to a life-time of 
helpless dependency. Not only the pa- 
tients were discouraged, but the nurses 
were too, for it seemed as if their ef- 
forts to help were almost futile. 

So our nurses asked for help in 
giving care to these people. The first 
request came from the Montreal stafif. 
After several months of planning, a 
nursing authority was brought from 
New York to conduct a course on 
modern rehabilitation nursing. The re- 
sults of this course were amazing ! The 
principles of the course were simple 
and emphasized better posture and 
body mechanics and simple exercises. 
Patients responded beyond all expec- 
tations and the nurses themselves were 
less fatigued at the end of the day. 
Instead of the former feeling of in- 
adequacy when a new patient suffering 
from a long-term illness was admitted, 
the nurses welcomed these patients as 
a challenging job. 

But Montreal was not an isolat- 
ed district and the nurses in other 
branches wanted and needed the same 
assistance in order to give their pa- 
tients the advantages of these newer 
techniques. So again, plans were made 
and through the National Office a 
country-wide program was planned 
in 1953 for all Victorian Order nurses. 

Not many years ago there was a 



fatalistic acceptance of physical dis- 
ability. Many of these patients were 
hidden away in back bedrooms and 
hospitals for the incurable. To have 
a helplessly handicapped person be- 
come a productive human being was 
thought to be extremely idealistic. But 
with a dynamic approach to this great 
problem we have seen results — some- 
times miraculous results. 

What is the nurse's role in the reha- 
bilitation program? Let us think for 
a moment of her responsibilities and 
how we may recognize and evaluate 
patients' needs in rehabilitation. First 
let us review the philosophy of reha- 
bilitation. We have heard it defined 
as the restoration of the individual 
to the fullest mental, social, vocational 
and economic usefulness of which he 
is capable. Henry D. Sayer said at 
the 35th Annual Meeting of the Inter- 
national Association of Industrial Ac- 
cident Boards and Commissions al St. 
Louis in 1949: 

Rehabilitation is not just medical 
treatment. It is training : it is the in- 
telligent approach to each case as pre- 
senting its individual needs ... It 
calls for leadership, the inspiration of 
the injured to help himself, the in- 
stilling in the injured person of confi- 
dence in himself, and a feeling that 
after all he has a useful place in the 
world. It cannot be forced on anyone . . . 
There are not m.any who do not want 
to improve their lot but they need guid- 
ance, encouragement and a type of 
leadership that has too frequently been 
lacking. 

We know that total rehabilitation 
is accomplished through the combined 
eflforts of many — doctors, nurses, 
physical and occupational therapists, 
social workers and others. We know 
that the needs of the whole person must 
be met to achieve maximum and total 
rehabilitation. 

Nursing has a vital place in any 
rehabilitation program. Rehabilitation 
nursing must be made a part of, or 
integrated into all nursing care. This 
means that it should start as early as 
possible. It is not really a third phase 
of medical care as some people like 
to call it, but a continuous process 
carried on from the first day of illness 
until the patient has reached the maxi- 
mum of his capabilities. It is the kind 
of nursing care that concentrates on 



206 



THE CANADIAN NURSE 



the needs of the whole person and aims 
to assist in restoring all sick and dis- 
abled people. It is wide in scope and 
comprehensive in nature ; it considers 
the totality of patient care and it al- 
ways has as its goal the restoration 
of the patient to a happv and meaning- 
ful life. 

To practise rehabilitation, the nurse 
herself needs above everything else a 
philosophy that leads to whole-hearted 
belief in the rehabilitation process. It 
may require a complete change of at- 
titude. Too often doctors and nurses 
consider chronic illness as hopeless and 
invalidism as inevitable. Their main 
interest seems to lie in the acute stage 
of illnesses. 

All nurses need to be given a better 
understanding of this new approach, 
this change in emphasis toward illness. 
It is not so much on doing things for 
the patient as in teaching him to do 
things for himself. 

For instance, a well meaning nurse 
may make a patient even more depend- 
ent than the limitations imposed on 
him by his disabilty. Such care can 
even destroy his own will to live 
independently. The rehabilitation at- 
titude is a vital, life-giving one that 
recognizes the importance of physical 
independence. There are very few com- 
pletely helpless patients or entirely 
hopeless situations. 

In one of our districts a nurse was 
called to give care to an 80-year-old 
woman with a right hemiplegia of a 
year's duration. Her family took it for 
granted she would always be helpless and 
they did everything for her. Even her 
left arm and leg became almost useless 
through disuse. The poor woman had 
lost interest in living and was just 
wishing for death. With the doctor's 
permission the nurse started doing pas- 
sive exercises. The patient was not very 
cooperative at first. The members of the 
family were sure all this activity would 
bring on another stroke, but the nurse 
encouraged them and explained the 
value of it. One day the woman was 
able to grasp a washcloth and wash her 
other hand. Gradually she got her hand 
to her face. A new goal was set each 
week. Now that she had a new interest 
in living, she met each visit by the nurse 
with anticipation. Within a few months 
she was able to walk. Both the patient 
and her family could not get over the 



evidences of her improvement. They 

regretted the fact that a whole year had 

been sacrificed unnecessarily. 
To practise rehabilitation nursing 
one must understand thoroughly the 
contributions of other health groups 
in order to work effectively with them, 
because teamwork is the core of the 
rehabilitation process. As public health 
nurses we need to know the resources 
available in the community. We need 
to be familiar with all of the programs 
that are being provided to assist dis- 
abled persons. Indeed, we may even 
need to stimulate action in setting up 
programs. We need to have a close 
association with hospitals so that pa- 
tients are referred for home care 
following their discharge. 

In order to teach patients effectively, 
nurses need a body of knowledge and 
an aptness with nursing skills that is 
rehabilitative in character. What are 
some of these skills and how can we 
evaluate the total rehabilitation nursing 
needs of a hemiplegic patient, for ex- 
ample ? 

There are a number of areas in 
which we must recognize rehabilitative 
needs and provide the nursing skills 
that are required. These are : 

Good nursing care with consideration 

for hygiene, nutrition, elimination, rest, 

sleep, recreation, etc. 
The prevention of deformity. 
The correction of deformity. 
Control of incontinence. 
Attention to speech problems. 
Retraining in ambulation and evalua- 
tion. 

Retraining the affected hand and arm. 
Psychological and spiritual problems. 
Self-care activities. 
Family education. 

We shall take it for granted that 
good nursing care will be provided. 

The skills required to prevent de- 
formity are those involving correct 
posturing by the use of positioning 
techniques and mechanical aids to keep 
the body in good alignment. Skill also 
is required in providing daily exer- 
cises, preventive in character and de- 
signed to keep all joints movable at 
their maximum range of motion. 

Contracture deformities must be pre- 
vented at all costs and as early as pos- 
sible. Skills in teaching self-care ac- 
tivities require much more knowledge 
and experience than many nurses have 



MARCH. 1959 • VOL. 55. No. 3 



207 



in this area, although V.O. nurses have 
practised this phase of rehabihtation 
for years. In this respect, many pa- 
tients and famiHes have designed ex- 
cellent self-care aids for use in the 
home. However, bed and wheel chair 
activities, eating, dressing, bathing, 
and toilet habits are definite techniques 
in rehabilitation that require much 
skill on the nurse's part if she is to 
incorporate them in her practise of 
nursing — and more important if she 
is going to expect her patient to benefit 
from her teaching. 

The correction of deformities is 
essentially the field of the doctor and 
physical therapist but the nurse may 
work cooperatively with them and 
assist wherever possible. 

In elevation and ambulation training 
the nurse has similar responsibilities. 
She must be skilled in crutch walking, 
gait-training, balancing exercises and 
the emotional problems inherent in 
these activities of daily living. She 
must continually guide the patient, 
encourage, instruct and motivate him 
to practise these procedures, even when 
they may have been initiated by some- 
one else. 

Speech rehabilitation is often one of 
the most difficult tasks, particularly for 
an inexperienced person. An under- 
standing nurse can give a great deal 
of help to the patient. In many of our 
branches there is no speech therapist 
available. In such cases we have sug- 
gested to our nurses that they might 
get some assistance from school 
teachers who have remedial reading 
classes. To help the patient communi- 
cate in his own particular situation 
is the basis of all speech training. 
There are few things more frustrating 
to a person than to be unable to ex- 
press himself sufficiently to be under- 
stood by others. 

It was a shock to Mr. Perry, a 
retired accountant to awake suddenly, a 
paralytic invalid unable to make his 
simplest want known. Fear and doubt 
troubled his thoughts as this threat- 
ening cloud shadowed his future. 

Reassurance flooded the caverns of de- 
pression as the physician explained his 
condition and the possiblities of rehabili- 
tation. He told the patient the Victorian 
Order nurse would visit daily at home 
to assist him in his struggle for inde- 
pendence. Thus it is no longer enough 



that a nurse bathe a patient, see that he 
is clean, free from pressure sores and 
comfortable. She has an essential role 
to fill in assisting the patient to regain 
some measure of his former activity 
and to help him live with his handicap, 
not use it as a crutch. 

On her initial visit the nurse showed 
that she was also a friend and adviser. 
Mr. Perry realized that here was a 
person who understood his difficulty 
and was eager to spur him on to victory. 
She explained that progress might be 
slow so that he would not become dis- 
couraged. She also enrolled the assistance 
of the family who adopted a positive 
attitude toward the patient's condition 
and showed they too were anticipating 
his return to a fuller life. Although 
he was unable to speak, the family 
included him in their conversation. On 
the advice of the nurse they refrained 
from speaking of his condition in his 
presence or referring to him in the 
third person. Such casual remarks could 
make the patient feel an "outcast," an 
invalid without hope. 

While giving the daily care, the nurse 
repeated one syllable words to the pa- 
tient in relation to his environment. 
She asked him to repeat these words 
when he could. Though Mr. Perry was 
unable to do this immediately, he ob- 
served no disappointment in his nurse 
and so was not discouraged. She in turn 
gave him easier goals, such as blowing 
a thin piece of paper across a mirror, 
so that he might feel the pleasure as- 
sociated with achievement. By encourag- 
ing him to participate in his personal 
grooming, he slowly regained his self- 
confidence. When awkward movements 
resulted in spilled food or sent tum- 
blers crashing to the floor, a sincere 
smile and the response "accidents will 
happen" cheered Mr. Perry to try again. 

Picture his joy and that of his family 
when he could repeat those nouns and 
action verbs the nurse had continued to 
say, such as food, hand, sit, walk. From 
the day his sigh only flickered the 
flame of a candle to the first time he 
said goodbye was a long, bumpy road 
for this patient, but the cloud had lifted 
and a rainbow appeared in the sky. The 
patience and repeated efforts of the nurse 
and the family were paying dividends. 
If his physical progress was slow, the 
change in his mental attitude was 
profound and he was developing under- 



208 



THE CANADIAN NURSE 



standable speech, so important in the 

process of his total rehabilitation. 

Occupational therapy is particularly 
important in the retraining of the affect- 
ed hand and arm of the hemiplegic pa- 
tient. It is well to teach him to make 
use of the paralyzed arm in every pos- 
sible way. For example, in writing a 
letter with the uninvolved hand the pa- 
tient may stabilize the writing paper 
with his paralyzed arm. Or in trying 
to feed himself, he may hold the plate 
in position with the paralyzed hand. 
The abilities that have been lost should 
be minimized and those that are left, 
stressed. 

An exceedingly important thing for 
the nurse to remember is that most 
patients who have suddenly become 
disabled need considerable reassurance 
in relation to their dependency during 
the period of emotional turmoil when 
they are just beginning to realize the 
nature and extent of their disability. 
The degree of dependency is balanced 
between the severity of the disability 
and the patient's resources for develop- 
ing new skills and interests. Even those 
patients who adjust and progress 
favorably may have occasional brief 
lapses or regressions when they need 
special encouragement and support. 

When patients do not accept their 
disability we should examine our own 
attitude. Have we met the patient's 
questions truthfully and objectively? 
The nurse should continually remind 
herself that she is treating not a body, 
a disabled organ, or an impaired func- 
tion but a fellow human being whose 
disability is an integral part of his 
total personality. The disability is not 
so much what the nurse thinks it is 
as what the patient thinks it is. 

When the needs of the handicapped, 
hemiplegic patient are met in all these 
areas of care which are largely physical 
and emotional in nature, there still re- 
mains much to be done in preparing 
the patient for his return to normal 
living in his own home and in the 
community. This social rehabilitation 
should run concurrently with his physi- 
cal and emotional rehabilitation. The 
family is brought into the program 
early so that their education may be 
made an integral part of the total 
process. This part of the program 
develops naturally. 

What are some of the physical fac- 



tors in the home that may interfere 
with successful home and family living? 
Such simple things as carpets, rugs, 
type of bed. the arrangement of the 
bedroom, width of the door for a 
wheelchair, bathroom facilities and 
arrangement, light switches, need to be 
considered. If the patient is a woman, 
adjustments in the kitchen set-up may 
be necessary. How will the family help 
the disabled one to adapt to his limi- 
tations ? Will they accept him as he is, 
reject him or over-protect him? 

What is the patient's attitude? 
Motivation is the keyword for reha- 
bilitation. Unhappily, it is not some- 
thing one person can simply give to 
another. However, the nurse is in a 
good position to know what incentive 
the patient needs to become motivated. 
What does he really want? What does 
the goal which the nurse thinks so 
desirable mean to him? Sometimes 
rehabilitation means merely being able 
to walk across a room or being able 
to feed oneself. One patient we had 
was an ardent gardener and his hope 
was that by summer he could get out 
to see his flowers. Another patient was 
looking forward to celebrating her 50th 
wedding anniversary that was six 
months away. 

The education of the family should 
be a part of the total rehabilitation 
program. Every contact between nurse, 
patient and family should be made a 
learning situation with use made of 
every opportunity. The family needs 
constant help in accepting the patient's 
disability and in understanditig his 
limitations, but his capabilities should 
always be stressed. The dangers of 
over-protection should be explained. 
They should be given a clear under- 
standing of the progress they can 
expect in the patient. They should be 
shown how to assist him in his self- 
care activities. They should be helped 
to understand the patient's social, voca- 
tional and emotional goals so that they 
can work with him in attaining them. 
While it is the hope of rehabilitation 
workers that all patients will achieve 
total independence this is not always 
possible. 

We believe rehabilitation is the 
ability to find ways and means to 
meet the various needs of the indi- 
vidual patient so that he may achieve 
some measure of happiness and inde- 



MARCH. 1959 • VOL. 55. No. 3 



209 



pendeiice. Rehabilitation nursing re- 
quires tact, insight and an awareness 
of the vital role of nursing in the reha- 
bilitation of the physically handicapped. 



It is a vast undertaking but if we as 
nurses meet the challenge we will have 
the immense satisfaction of seeing dis- 
abled patients learning to live again. 



The Rehabilitation Team 



M. LORENA McCOLL 



Coming together is a beginning ; 
Keeping together is progress ; 
Working together is success. 

— Henry Ford 

SEVENTEEN-YEAR-OLD Doris had fallen 
and fractured her back. This is a 
catastrophe at any age but, when you 
are so young, with the usual teenager 
enthusiasm for an action-packed life, 
finding yourself with two useless legs 
is a tragedy. What can life possibly 
hold for you from now on ! 

Doris was introduced to hospital 
life from a Stryker Frame with Crutch- 
field tongs holding her injured spine 
in position — a frightening situation 
for anyone ! Although she did not 
realize it at the time, her injury and 
its attendant complications were to 
involve several people representing a 
variety of professions and occupations 
— all with a single objective, her res- 
toration to as normal a life as possible. 

The people who formed the health 
team came from the hospital and the 
community. They had to be fully aware 
of their relationships with one another 
and of their common objectives : 

1. To achieve maximum function for 
the patient's disabled body — in par- 
ticular, the affected areas. 

2. To maintain unaffected areas in 
optimum condition. 

3. To assist the patient to adjust 
physically and emotionally to living a 



Miss McColl who is now assistant 
secretary at CNA National Ofiice, was 
general convener of the nursing section 
of the International Northern Great 
Plains Conference on Rehabilitation and 
Special Education held at the University 
of Saskatchewan, Saskatoon in 1958. 



life within new limits but to the fullest 

extent of her capabilities. 

Each member as it became his or her 
turn to participate in the program be- 
came the most important link in Doris' 
progress to rehabilitation. 

The Professional Nurse 

One of Doris' earliest acquaintances 
was her nurse. To this member of the 
team fell the responsibility for creat- 
ing the permissive atmosphere that 
would, it was hoped, secure the co- 
operation, respect and liking of the 
frightened and insecure youngster. Un- 
less Doris could be made to feel at 
ease and secure in the knowledge that 
everyone was working towards her 
recovery, the efforts of the team would 
be in vain. You can not help the pa- 
tient who does not want to be helped. 

Eventual rehabilitation had to be 
the goal right from the time of ad- 
mission. Doris had to be encouraged 
to help herself as much as possible as 
soon as her condition permitted. Her 
nurse initiated self-care at the earliest 
opportunity, gradually increasing the 
duties that Doris could learn to per- 
form for herself. The nurse, in turn, 
had to learn to restrain her natural 
tendency to do things for Doris and 
stand aside until her assistance was 
essential. With each victory over a 
task, no matter how small. Doris' self- 
confidence grew. 

The nurse not only participated sub- 
stantially in Doris' physical care but 
provided the instruction and super- 
vision necessary for those who shared 
this responsibility with her. She help- 
ed to coordinate the eiTorts of the rest 
of the team. In various instances, it was 
the nurse's observations that provided 



210 



THE CANADIAN NURSE 



the foundation upon which the next step 
towards rehabihtation could be taken. 
In addition to her other duties, the 
nurse had to reahze the importance 
of being a good Hstener. Doris w-as 
frightened, insecure, hostile towards 
the fate that had crippled her. Having 
gained her confidence, the nurse be- 
came Doris' confidante. Into her ears 
poured the story of a small child bandi- 
ed about from one relative to another 
when she most needed a stable home ; 
of a young girl's dreams for the future 
and her fears that future happiness 
had been destroyed by her injury. The 
nurse tried to foster a more optimistic 
outlook, to thwart tendencies toward 
self-pity and to build up her patient's 
self-esteem and self-confidence. This 
was a task that needed the help of 
others especially prepared to deal with 
emotional upheaval attendant upon a 
disabling injury. 

The Psychiatrist, Psychologist 
AND Therapists 

The person who must adjust to a 
life limited by physical disability natu- 
rally shows considerable emotional re- 
action. The psychiatrist helped the 
nurse to understand Doris, to see how 
the patient's feelings would affect her 
behavior. He helped the patient to face 
the difficulties created by her injury 
and to accept the fact that her activities 
must of necessity be limited. The psy- 
chologist through the various tests at 
his disposal was in a position to assess 
the patient's capabilities and to advise 
on the course that her future training 
might follow. The various therapists — 
occupational, recreational, etc. — could 
begin while the patient was still in 
hospital to develop her capabilities. Her 
clergyman provided spiritual comfort 
and also assisted Doris in facing her 
problem and accepting it. 

The Nursing Assistant 

She shared with the nurse the re- 
sponsibility for the patient's physical 
care. Doris was in need of consci- 
entious skin care, frequent change of 
position, constant observation, pro- 
tection against pulmonary complications 
and a variety of other attentions. 

The nurse provided the instruction 
necessarv to overcome anv hesitancv 



the nursing assistant might have about 
caring for the patient on the Stryker 
Frame and with the tongs in position. 
She emphasized the special factor about 
the patient's condition that made rou- 
tine nursing measures of such supreme 
importance — the nerve damage with 
the accompanying paralysis and loss of 
muscle function. 

The assistant nurse provided valu- 
able help in ensuring routine nursing 
care measures with the frequency de- 
manded. 

Medical and Surgical Care 

On admission, immediate attention 
was focussed on Doris' injured back 
and the measures required to promote 
good bone healing. Even here, re- 
habilitation was the central if unspecifi- 
ed aim. The Stryker Frame removed 
obstacles to good nursing care — 
particularly skin care. The Crutchfield 
tongs helped to maintain the very 
necessary good body alignment. 

One of the major physical and psy- 
chological problems that must be faced 
very early by the paraplegic patient 
is an incontinent bladder. Rehabili- 
tative measures must be started as 
early as possible so that bladder tone 
can be maintained as close to normal 
limits as possible. A cystometrogram 
determined Doris' bladder capacity and 
an indwelling Foley catheter solved 
the bed-wetting problem temporarily, 
reducing as well the hazards to the 
skin. Prophylactic drug therapy was in- 
stituted to counteract possible bladder 
infection and forced fluids — water 
and nonalkalizing fruit juices — kept 
the urinary system functioning at maxi- 
mum capacity. 

Later, cystonietric readings indicat- 
ed that Doris might be able to develop 
an automatic bladder — one that will 
empty when a certain degree of filling 
has been reached. This was to be an 
important factor in Doris' progress 
since it would make a permanent in- 
dwelling catheter unnecessary. Tidal 
drainage was started as the first step 
towards this objective while she was 
still a bed patient. 

About two and one half months 
after Doris' injury, spinal x-rays show- 
ed that healing was progressing most 
satisfactorily. She was moved to a 
Gatch bed with a sectional mattress 



march, 1959 • VOL. 55, No. 3 



211 



that allowed for the panning proce- 
dures required in establishing bowel 
and bladder control. From this, Doris 
soon progressed to a wheel chair. 

Rehabilitative measures proceeded 
more rapidly now. Doris was encour- 
aged to do everything possible for her- 
self — bathing, feeding, turning, get- 
ting into and out of bed. The team 
bestowed generous amounts of praise 
and exercised considerable patience 
and self-restraint in order to give Doris 
the opportunity to attain her goals. 

The next steps in the development 
of the automatic bladder were taken. 
The tidal drainage was discontinued. 
As soon as Doris reached the stage 
of sitting on a commode, the indwell- 
ing catheter was removed and attempts 
at normal voiding began. Catheter- 
ization for residual urine was done 
at intervals to determine how well 
the bladder was emptying. When the 
amount retained was over 60 cc, Doris 
was advised to apply light suprapubic 
pressure. Restricting fluids before bed- 
time helped to control the bedwetting 
problem. At first, the interval between 
each voiding was very short but as 
bladder capacity increased and muscle 
tone improved, the time intervals be- 
came longer. Doris used an alarm 
clock to waken herself and finally 
reached the stage where she was waken- 
ed once each night and could handle 
the problem easily during the daytime. 

Paramedical Services 

The occupational therapist came to 
the fore when Doris was able to sit up 
in bed and then in a chair. Shell 
jewellery, embroidery and similar crafts 
kept her busy and happy. Soon she 
progressed to recreational activity at 
wheel-chair level. 

Shortly afterwards, her doctor decid- 
ed that Doris should begin crutch- 
walking. This was to improve her gen- 
eral circulation and prevent calcium 
deposits in the kidneys and bladder. 
So, with instruction, assistance and 
encouragement from the physiothera- 
pist, Doris began the business of learn- 
ing t@ walk again with long leg braces 
and crutches. 

The Hospital Auxiliary Worker 

The dav that Doris went on her 



first excursion away from the hospi- 
tal was a red letter one. A member 
of the Ladies' Auxiliary acted as 
chauffeur. Both driver and passenger 
received full and careful instructions 
concerning all foreseeable situations 
in which they might find themselves. 
The venture proved so pleasant and 
was carried out so successfully that it 
w'as repeated several times. Doris loved 
being the centre of attention and her 
self-confidence expanded noticeably 
when she realized that her disability 
did not prohibit her from normal social 
activities. 

The Public Health Nursi^ 

Eventually the time came when 
Doris was judged fit for transfer to 
a vocational centre and special train- 
ing. At this stage the various resource 
personnel in the community enter the 
picture, one of the first being the public 
health nurse. 

Her contribution towards the re- 
habilitation of the injured person re- 
turning to the community may be 
summed up as follows : 

1. She promotes a sane, constructive 
attitude within the community towards 
physically handicapping conditions. 

2. She works jointly with all com- 
munity agencies in bringing about such 
psychological, social and economic ad- 
justments as may be indicated in the 
best interest of the physically handi- 
capped. 

3. She assists, when needt-d, in arrang- 
ing for educational and vocational train- 
ing, and in interpreting the patient's 
needs to parents, teachers and com- 
munity. 

4. She works with teachers to inter- 
pret the patient's disability and helps 
to plan the school program. 

5. She helps the family adjust to the 
fact that the patient has a handicap and 
assists in planning as normal a life as 
possible. 

6. She supplements medical instruction 
by providing the follow-up care neces- 
sary for the various aspects of patient 
care to be carried out in the home after 
discharge. 

7. She encourages the patient and the 
family to continue medical supervision. 

8. She continues to motivate the pa- 
tient towards rehabilitation, realizing 
that it is impossible to instruct or guide 



212 



THE CANADIAN NURSE 



an unwilling patient, family or com- 
munity. 

9. She teaches the patient how to 
maintain good health, encourages self- 
care, and helps the family to exercise 
restraint in offering assistance. 

10. She helps the patient to continue 
with medical instructions and avoid the 
complications that might otherwise de- 
velop. 

We do not really know what the 
scope and limitations of the nurse 
in rehabilitation are or should be. 
Nursing education has traditionally 
been directed towards the acutely ill 
and further emphasis on restoring the 
patient as a useful, productive citizen 
is required. 

Other Community Personnel 

Once she has completed her vo- 
cational training Doris should be placed 
in a job where she can become self- 
supporting or partially so. This is the 
ultimate aim of the whole rehabilitation 
program — to make her a useful mem- 
ber of societv. 



The help of a Placement Agency 
may be required in obtaining employ- 
ment. Society in general still requires 
considerable education concerning the 
worth of the physically disabled in 
business and industry. Many employers 
are reluctant to employ the disabled 
person. Education of the public is a 
job for all members of the health team 
either in the institution or in the com- 
munity. 

This has been the story of the res- 
toration of one disabled person to a 
useful role in society. The responsibility 
rests not upon any one or two pro- 
fessions but is shared by the community 
resources and the institution alike. The 
patient too, must be made to feel that 
she has some responsibility for her 
recovery. 

Rehabilitation must be the aim from 
the very beginning. Treating the injury 
alone is not sufficient. The mental, 
emotional and spiritual aspects must 
receive adequate consideration and the 
individual must be stimulated to live 
life to his fullest capabilities. 



Instruction in first aid may now be given 
under very realistic conditions through use 
of the synthetic casualties developed by the 
Alderson Research Laboratories, Inc., New 
York. Moulagcs depicting a variety of in- 
juries and which can be applied to the body 
of a living demonstrator can be obtained. 
These masks have been constructed so that 
bleeding from arteries and veins can occur 
which can be controlled only by proper medi- 
cal methods. For classroom use or field 
use, a lifelike plastic model can be obtained. 
Hard plastic bones have been arranged to 
simulate fractures that can be set ; wounds 
of every nature bleed in a natural manner. 
First aid personnel can now become adjusted 
to the shock of severe injury and emergency 
conditions under realistic circumstances. 

Colostomy training moulages to help the 
patient become adjusted to his colostomy 
and its care in advance; a hemostasia trainer 
to give practice in tying off severed blood 
vessels and a giant oral thermometer for 
demonstration purposes are also available. 
* * * 

Experience is the name everyone gives to 
his mistakes. — Oscar Wilde 



\'ery little is known about hospital equip- 
ment during the first centuries after the birth 
of Christ . . . Some information relative to 
beds is available from medieval times (A.D. 
700-1500). It is interesting to note how 
hospitals obtained many of their beds. In 
France, the wealthy and the canonites 
(religious people) donated or willed their 
beds and bedclothes to hospitals. In the 
16th century . . . the beds among the nobility 
became very rich and expansive. Elaborate 
bedclothes were fashioned of gold, silver 
and silk. In fact, bedclothes and beds be- 
came so expensive that many people who had 
intended to donate or will their beds to 
iiospitals decided to give only the bedclothes 
and not the beds. One hospital in France, 
however, took the case to Parliament and in 
1597 the canonites were forced to donate the 
entire bed with all the bedclothes, or con- 
tribute three to five hundred pounds. What 
had been a donation became a tax. 
* * * 

Overnight accommodation for wives and 
relatives of hospitalized patients at DVA 
hospitals is provided at the eight Red Cross 
Lodges. 



MARCH, 1959 • VOL. 55. No. 3 



213 



The Story of JohHuy 



Lorraine F. Miller 



WHAT OF THE PATIENTS who IIO 
longer need hospital care, but who 
still require treatment that may be 
given in the home? How can the visit- 
ing nurse fulfill her role on the reha- 
bilitation team? 

I am going" to tell you about Johnny 
who had received the benefits of com- 
bined care from hospital personnel, and 
then was discharged to his home for 
continuation of treatment and rehabili- 
tation. Johnny's physician felt that he 
had been in the hospital too long. His 
required care was such that it could 
be given by his mother and the visiting 
nurse service. 

Johnny is one of a family of three 
boys. He is fourteen, with a mental age 
of nine, and had reached grade three 
in school before the accident that took 
the life of his elder brother and result- 
ed in severe burns for Johnny. After 
lengthy hospitalization and extensive 
plastic surgery, he was ready for dis- 
charge. There was marked scarring of 
his upper chest, back, legs and part of 
his neck. Contractures of the muscles 
of his legs and groins had resulted 
in a shuffling gait. 

Living conditions were only fair. 
The family occupied a four-room house 
with a bathroom in the basement. The 
income was low. Family relationships 
were a problem. The parents had 
rejected Johnny because he was dull. 
His care in the home had been and 
would be adequate, but love and at- 
tention were lacking. In spite of this, 
Johnny was glad to be going home. 

Johnny's story illustrates how the 
health team personnel cooperated in 
planning for the best possible care, 
and how hospital services were con- 
tinued in the community. 

A referral was arranged by the 
physician, and his orders were for- 
warded to the visiting nurse organ- 
ization. The hospital medical social 
worker wrote a lengthy report on 
Johnny, his reactions, family attitudes 



Miss Miller is district director with 
the Victorian Order of Nurses in Sas- 
katoon. 



while he was in hospital and the im- 
mediate outlook. A home visit was 
made to assess the situation and see 
how Johnny's needs could be met. Be- 
cause Johnny's exercises were so im- 
portant, it was arranged for the nurse 
in the district to have a demonstration 
conference with the physiotherapist at 
the hospital. These two members of the 
team planned together for Johnny's 
program of physical therapy. This 
nurse, in turn, demonstrated to the 
remainder of the visiting nursing stafif 
at a group conference. Every member 
was made aware of the correct method 
of doing the exercises. 

Advice and help were given to the 
mother in preparing and sterilizing 
the small dressings still required. When 
sleeping arrangements were adjusted 
so that Johnny could have a single 
bed with a plywood fracture board 
to ensure good positioning, he came 
home. 

The frequent tub baths posed a 
problem. For a short time the visiting 
nurse assisted but gradually Johnny's 
mother took over this task. The family 
were urged to assist Johnny only when 
necessary, and to make him self-suffi- 
cient. Johnny frequently attempted to 
use his younger brother as "picker- 
upper" or " toy-carrier" and this had 
to be discouraged. 

Reports were given to the medical 
social worker and the physician from 
time to time. Attendance at clinic was 
stressed as necessary to Johnny's con- 
tinued improvement. 

Our part of Johnny's program of re- 
habilitation continued over a period 
of almost a year. During this time 
Johnny's mother became pregnant, and 
we gave prenatal advice. When his 
baby sister was born Johnny potu'ed 
affection on her. 

We endeavored to arrange for 
Johnny fo attend Crippled Children's 
Camp, but although both parents con- 
sented, Johnny refused to leave home. 
The Salvation Army assisted in secur- 
ing a bicycle for him, and the Christ- 
mas Cheer Fund provided toys at 
Christmas for all three children. 



214 



THE CANADIAN NURSE 



What of Johnny's future? Physi- 
cally his rehabilitation has been suc- 
cessful. The efforts of the hospital 
and community services can be said to 
have achieved their objective. It is not 
likely that Johnny will return to school. 
He has demonstrated a capacity for 
carpentry and could probably benefit 
from vocational classes. Under super- 
vision and with training in those areas 
for which he has shown an aptitude 
he can ultimately become a more valu- 
able member of the community. 



Regardless of individual results and 
of whether we achieve complete success 
or have to recognize some failures — 
and no one can succeed all the time — 
this is an example of how hospital and 
community personnel can work to- 
gether. In the hospital, in the com- 
munity, the various members function- 
ed as a rehabilitation team to take the 
patient to the limit of his capabilities 
and return him to family and to so- 
ciety, emotionally and physically able 
to enjoy life and the years ahead. 



The llehabilitation of Mrs. Moritz 



Dorothy Butler 



THIS IS THE FOLLow-up account of 
the care given Mrs. Moritz, whose 
problem was discussed in the May, 
1958, issue of The Canadian Nurse. 
The original article, by Miss Brenda 
Bauman of the Allan Memorial Insti- 
tute of Psychiatry, told how the 23- 
year-old blond woman was admitted to 
the Allan for observation. There was 
a "lack of physical findings and a 
provisional diagnosis of hysterical per- 
sonality." One month later, she was 
found to be suffering from Wilson's 
Disease, known as Copper Intoxication. 
Copper, instead of being excreted, was 
deposited in the basal ganglia of the 
brain, with resultant progressive Park- 
insonism. She was treated with Pena- 
cillamine, a drug therapy for this dis- 
ease only recently discovered. 

This report deals with the post- 
hospital care of Mrs. Moritz which was 
provided by the Victorian Order of 
Nurses, Greater Montreal Branch. 

The Victorian Order of Nurses, at 
the request of the Allan Memorial In- 
stitute, a unit of the Royal Victoria 
Hospital, has been providing follow-up 
nursing care for patients in the com- 
munity on discharge from the unit or 
attending the day clinic. These visits 
provide supportive care for the patients 
and their families and also provide the 



Miss Butler is a staff nurse with the 
Greater Montreal Branch of the Vic- 
torian Order of Nurses. 



link between the hospital and the pa- 
tient in his own home. This, then, 
is how the Victorian Order was called 
into the case of Mrs. Moritz. 

When she was ready to go home, 
the hospital arranged a predischarge 
conference to discuss plans for her re- 
habilitation. This meeting was attend- 
ed by hospital personnel and the Vic- 
torian Order of Nurses. The psy- 
chiatrist reviewed Mrs. Moritz' history, 
her background, diagnosis on admission 
and diagnosis of Wilson's Disease after 
investigation. He outlined the symp- 
toms and treatment of the disease 
which are covered in the previous 
article. 

Mrs. Moritz was brought in and 
introduced to me as the nurse who 
would visit her at home. Her tremors 
gradually subsided as she grew more 
secure in this familiar setting. She 
conversed freely with hospital person- 
nel whom she knew and talked with 
me about my forthcoming visits to her 
at home. After the patient left, I was 
able to ask for information and ad- 
vice. The predischarge conference had 
proven valuable because it : 

1. Enabled the patient to meet the 
nurse who would visit her at home. 

2. Provided me with valuable back- 
ground information regarding her hospi- 
talization. 

3. Brought me into contact with hospi- 
tal personnel. 



MARCH. 1959 • VOL. 55. No. 3 



21S 



4. Presented an opportunity to discuss 
common problems of patient care. 

5. Helped us discuss short- and long- 
term planning. 

Planning is essential for all patient 
care but in this case, the predischarge 
conference was helpful in preparing 
Mrs. Moritz for the strict regime she 
must now follow for the rest of her life 
— any deviation from this regime 
would result in her becoming a help- 
less invalid with little hope for sur- 
vival. The plan was : 

1. To help Mrs. Moritz adjust from 
the secure hospital setting to her home, 
it was necessary to meet her great de- 
pendency needs, while encouraging her to 
become increasingly independent. 

2. To supervise her medication, her 
fluid intake — which had to be great 
— and her diet. 

3. To encourage Mrs. Moritz to care 
for herself, her family and her home. 
This meant helping her adjust to such 
a daily routine as dressing herself, eat- 
ing, care of an 18-month-old child and 
responsibility for her houseliold. 

4. To prevent readmission to hospital 
by encouraging her to follow her regimen 
and promote independence. 

5. To teach the family to encourage 
and support Mrs. Moritz to do every- 
thing for herself and to impress on the 
family that if everything was done for 
her, it would be detrimental to her 
recovery. 

It is ten months since Mrs. Moritz 
returned to her home and I can now 
describe her rehabilitation. By having 
a well-defined plan, each visit provided 
additional encouragement for the pa- 
tient and me. It was decided, in order 
for her to gain confidence, that she 
would be visited daily at approximately 
the same time and by the same nurse. 
The doctor had warned that although 
this was necessary and desirable at first, 
Mrs. Moritz had great dependency 
needs which, if fully met, would render 
her permanently an invalid. If we were 
not successful in reducing the fre- 
quency of our visits and changing the 
nurse, Mrs. Moritz would only be 
transferring her dependency needs from 
the hospital to us and this would not 
be real progress. The doctor had em- 
phasized also that we would have to 
"be positive in our statements to Mrs. 
Moritz, regarding the necessity of her 
becoming independent. 



When I visited Mrs. Moritz, I found 
that the family consisted of herself, 
her husband, an 18-month-old adopted 
child and Mrs. Moritz' mother, who 
had come from Nova Scotia. This pre- 
sented a problem because the mother 
had assumed complete responsibility, 
making it difficult for us to carry 
through our plan to make the patient 
fully independent. Added to this dif- 
ficulty were the problems of poor 
marital relations and a strained rela- 
tionship between the husband and 
mother-in-law. In the predischarge 
conference, the doctor had stressed 
the importance of having the mother 
return to Nova Scotia because of family 
tension. Moreover, since the husband 
was frequently out of town, the 
mother's presence encouraged Mrs. 
Moritz to be dependent. 

I visited daily, around lunchtime, 
and found that Mrs. Moritz was dis- 
couraged and despondent. Her tremors 
were pronounced, her coordination 
poor. She wore pyjamas and was con- 
stantly untidy because she felt unable 
to dress herself. It was extremely 
difficult for her to manage zippers 
so buttoned dresses were suggested. 
I encouraged her and gradually she 
was able to dress herself prior to my 
arrival. 

She was unable to drink as much 
as she needed because she could not 
turn on the tap. She spilled fluids 
and dropped glasses. I suggested that 
one or two large plastic pitchers of 
water be left by her husband and that 
she use straws. This enabled her to 
get the required fluid intake. 

Her lunch was also a problem be- 
cause she felt unable to light the gas 
stove. I suggested that sandwiches and 
hot soup be prepared and left in a 
thermos for her by her husband. These 
measures, I made clear, were to be 
considered temporary and woidd be 
discontinued as soon as her shaking 
was more controlled. 

All the suggestions were followed 
and it was not too long before she 
was preparing her own meals. Only 
one project at a time was undertaken 
since there were so many things that 
Mrs. Moritz felt unable to do. She 
could not plug the vacuum cleaner 
into the wall socket so her husband 
did this before he left. The bedroom 
was small and bedmaking presented a 



216 



THE CANADIAN NURSE 



problem. Rearrangement of the furni- 
ture allowed her more room to move 
around the bed. It was necessary to 
help Mrs. Moritz plan a schedule of 
her daily activities so that she would 
not attempt more things than she could 
manage. 

Wanda, the adopted child, became 
quite unruly on Mrs. Moritz' return 
from hospital. The patient often ex- 
pressed feelings of physical inability 
to care for the youngster. But in time, 
and with help, she was well able to 
manage. Wanda contracted measles 
and this gave me an opportunity to 
teach the care of a preschool child — 
diet, toilet training and discipline. 

Mrs. Moritz' mother accepted tem- 
porary employment in the city. Eventu- 
ally, she returned to Nova Scotia with 
the strong desire that her daughter 
would come and live with her there. 

Although the disease was now un- 
der control, the tremors less pronounc- 
ed and the patient able to do more and 
more for herself she expressed a desire 
to return to hospital or join her mother 
in Nova Scotia. During the regular 
weekly visits to the doctor, he made 
it clear that it was impossible for her 
to go to Nova Scotia to live but that 
she could visit there for the summer 



months if she continued to improve. 

This proved an incentive since the 
family was a closely-knit group. When 
she left for the summer vacation, her 
tremors had almost disappeared. She 
went to a city where there was a branch 
of the Victorian Order of Nurses and 
we referred her to them, sending a 
detailed summary of our service and 
information received from the Allan. 

After Mrs. Moritz had been in Nova 
Scotia for two months, we received 
a letter from the Branch there, notify- 
ing us that she was returning to Mont- 
real. Visits were resumed. Today, after 
ten months of continuous service, Mrs. 
Moritz has not required readmission 
to hospital and has been' dismissed 
from psychiatric service. Mfs. Moritz' 
progress has been most encouraging ; 
she has assumed responsibility for tak- 
ing her own medication, is able to care 
for herself and family and, more im- 
portant, is able to exercise control over 
her emotions. The progress made by 
this patient demonstrates the value of 
a close collaboration between the hospi- 
tal and a community health agency. 
The Victorian Order of Nurses ap- 
preciates having had the opportunity 
of participating in the rehabilitation of 
this patient. 



Remarkable progress has been made in re- 
ducing the number of new cases of blindness 
among children. Not only has blindness due 
to infectious diseases decreased sharply 
among school-age children, but loss of sight 
due to administering oxygen in high concen- 
tration to premature infants has become rare. 

The most frequent causes of blindness often 
have their onset in middle and later life. 
They include specific eye conditions of un- 
known etiology, in particular glaucoma, 
cataract, and such general disorders as ar- 
teriosclerosis, high blood pressure, nephritis, 
and diabetes. Males have a higher blindness 
rate than females partly as the result of the 
higher incidence among males of blindness 
due to accidents and partly due to the earlier 
development of arteriosclerotic and other 
degenerative changes. 

A study showed that half the cases of 
blindness could have been prevented. Early 
diagnosis and treatment of pathological eye 
conditions are the best available means to 



conserve sight. Periodic health checks, 
particularly in people past middle age, 
should include examination of the eyes for 
glaucoma and cataract, as well as for changes 
due to degenerative vascular diseases. 
— Meropolitan Information Service. 
* * * 

A compliment is something like a kiss 
through a veil. — Victor Hugo 




SERVING FOR YOU 

for 50 Years 
1909-1959 



MARCH. 19.59 • VOL. 55. No. 3 



217 



Irsing Care of the Thoracic Surgical Patient 



J. A. HiNSON, E. E. Oleksyn, B. Sc. and C. A. Dafoe. M.D., F.R.C.S. 



As THE NUMBER of patients undergo- 
ing thoracic surgery increases, it be- 
comes imperative that nurses acquaint 
themselves with the specific nursing 
care involved. Recognizing this fact, 
the University of Alberta Hospital 
has organized a Thoracic and Cardio- 
vascular Unit. Here the patients receive 
specialized care provided by experi- 
enced graduate nurses, and student 
nurses acquire knowledge and practice 
under close supervision. In the follow- 
ing article, an attempt will be made to 
mention various diseases encountered 
and to describe the pre- and postoper- 
ative nursing care as it is given and 
taught here. 

On our unit, the most common dis- 
eases of the lungs requiring surgery 
are: bronchogenic carcinomas, bron- 
chiectasis, benign tumors of the lung, 
lung abscesses and tuberculomas. Other 
operable conditions of the chest are : 
diaphragmatic hernias, esophageal car- 
cinomas and diverticuli, and tumors 
of the mediastinum such as neurofibro- 
mas, thymomas, dermoids, etc. Surgery 
of the aorta and heart includes repair 
of aortic aneurisms, coarctation of the 
aorta, patent ductus and mitral stenosis. 
The Cardiac Recovery Room is also 
located on this unit. Patients undergo- 
ing intra-cardiac surgery for congenital 
and acquired heart diseases with the 
aid of the pump oxygenator receive 
their care as provided by the cardiac 
team.* 

All admissions for chest investi- 
gations to our unit receive the fol- 
lowing tests : 

Complete blood count, sedimentation 
rate, hemoglobin, hematocrit, Wasser- 
mann, complete urinalysis and three con- 
secutive sputum specimens for culture 
and sensitivity. Chest x-rays are taken 
as ordered and chest physiotherapy is 
commenced by the therapist. Additional 
routine for cardiac investigations in- 



Dr. Dafoe and the nurse authors are 
cooperative members of the team work- 
ing on the Thoracic and Cardiovascular 
Unit of the University of Alberta Hospi- 
tal, Edmonton. 



eludes urea nitrogen, serum cholesterol, 
C reactive protein and anti-streptolysin 
"O" titre. An electrocardiogram, cardiac 
fluoroscopy and ear oximetry are usually 
done. Weights and blood pressures are 
recorded daily and specific attention is 
focused on digitalization, diuretics and 
diet for cardiac patients. 
The diagnostic procedures classed 
as minor operations are as follows : 
bronchoscopies, bronchograms, esopha- 
goscopies, left atrial pressures, car- 
diac catheterizations, angiocardiograms 
and aortograms. Breakfast is omitted 
for these procedures but no skin 
preparation is required except for an 
aortogram, in which case the left side 
of the posterior chest is shaved, if 
necessary. Postoperatively, the blood 
pressure is taken once when the patient 
returns to the ward, and then as often 
as is indicated by his condition. The 
patient receives nothing by mouth for 
one hour, then all medications and 
diet are resumed. Postural drainage is 
instituted following a bronchogram to 
facilitate more rapid drainage of the 
radio opaque dye which had been in- 
stilled into the bronchi. 

When it is decided that a patient 
will be submitted to major surgery, 
he is given a high protein, high ca- 
loric diet supplemented by vitamin 
therapy with emphasis on ascorbic 
acid. In this way, the general con- 
dition is improved and postoperative 
healing is promoted. Two days prior 
to surgery a urinalysis is done and 
the hemoglobin, hematocrit and urea 
nitrogen are again checked. Blood for 
transfusion is ordered and is available 
for use in the operating theatre. Ad- 
ditional blood is on hand for post- 
operative use. Chest physiotherapy is 
intensified, with emphasis on teaching 
deep breathing and effective coughing 
measures to be used postoperatively. 
The aims of this physiotherapy are : 
to increase the respiratory function to 
its full capacity, to cleanse and main- 



*Refer to "Open Heart Surgery using 
Total Cardio Pulmonary Bypass." The 
Canadian Nurse, .August, 1958 



218 



THE CANADIAN NURSE 



tain a clear bronchial tree and to in- 
struct the patient in his postoperative 
responsibility. Arm and leg exercises 
are also taught and their importance 
stressed. 

A skin preparation is done the day 
prior to surgery. This includes a shave 
from the chin to the iliac crests, the 
anterior and posterior thorax, the 
axillae and down the arms to the el- 
bows. The thorax is cleansed with 
Phisohex three times during the pre- 
operative day. A cleansing enema is 
given after supper ; the patient is settled 
comfortably for the night and an h.s. 
sedation given to ensure a restful 
night's sleep. 

On the morning of operation, the 
preoperative sedation is given as order- 
ed by the anesthetist. If the patient 
has been on digitalis, the daily dose 
is given preoperatively. If the surgery 
is being performed to correct an aortic 
aneurism, before the preoperative seda- 
tion is given, a Levine tube and a 
Foley catheter are inserted. Gentle 
enemas are given until the return flow 
is clear. These measures are taken 
to ensure that no undue pressure will 
be exerted on the graft postoperatively. 
The thoracotomy unit is set up with 
meticulous care. The anesthetic bed is 
made and the following equipment is 
assembled and placed on the locker: 
Cellu-wipes. kidney basin, an arm- 
board padded with soft gauze, gauze 
bandage, lA" and 2" adhesive tape, auto- 
clave tape and safety pins. Also ready 
for use is the intravenous standard, the 
blood pressure apparatus and a steam 
kettle. The oxygen gauge and humidi- 
fier bottle are connected to the wall jet 
and a nasal oxygen catheter of appro- 
priate size is attached. The wall suction 
apparatus is prepared for use. A nasal 
suction tray and a mouth care tray are 
also placed at the bedside. 
The unit is now readv for the pa- 
tient's return. 

When the chest is opened at oper- 
ation the state of negative intrapleural 
pressure is disrupted and the lung col- 
lapses. In this state it has very little, 
if any, function. If there are no post- 
operative leaks in the lung, such as 
may result from resection of part of it, 
then it is a simple matter to evacuate 
the air from the pleural space at the 
conclusion of the operation and the 
lung should re-expand. A constant leak 



of air into the pleural space will not 
allow re-expansion of the lung unless 
the air can be removed as rapidly as 
it accumulates. The underwater seal 
drainage system is used for this pur- 
pose. The positive pressure of coughing 
and deep respiration is probably the 
most effective means of removing the 
air from the pleural space rapidly. 
However this may be aided by negative 
pressure of minus ten to minus forty 
centimeters of water, produced by some 
form of vacuum pump, such as a Sted- 
man pump or a thoracic thermotic 
suction. 

When the patient returns from the 
anesthetic recovery room via stretcher, 
certain precautions must be taken in 
moving him to the bed. The chest 
drainage tube or tubes must be care- 
fully checked to make certain that they 
are not taped to the stretcher and that 
there is no pull or tension exerted on 
them while the patient is being moved. 
The tubes must never be raised above 
the level of their insertion into the 
chest wall. 

After the patient has been placed 
flat in bed, the dressing is inspected 
to see that it is intact and if any signs 
of hemorrhage or abnormal drainage 
are present. The drainage bottle is 
taped securely to the floor with 2" 
tape and calibrated autoclave tape is 
placed on the side of the bottle. This 
tape enables a fairly accurate estimation 
of drainage to be kept. More than 
500 cc. of drainage in the first 12 hours 
may be considered excessive and any 
rapid increase in the amoimt of drain- 
age demands explanation. All connec- 
tions of the tubing between the patient 
and the underwater seal drainage bot- 
tles are taped with half inch tape to 
prevent air leakage and to keep the 
connections secure. In pinning the tube 
to the bed, care must be taken to ensure 
a continuous "downhill" run from the 
patient to the bottle. These drainage 
tubes must be "stripped" every few 
minutes to prevent formation of blood 
clots. "Stripping" is continued until 
the drainage is serous. 

On our unit the blood pressure, 
pulse and respirations are checked 
every 15 minutes until stable, every 
one-half hour for two hours, then every 
two hours for 24 hours. Also included 
in our check of vital signs are : the 
color of the lips, ear lobes, nail beds 



MARCH. 1959 • VOL. 55. No. 3 



219 



and peripheral "blanching" signs of the 
hands and feet. The patient is placed 
in low Fowler's position when the 
blood pressure is stable because this 
position facilitates drainage and ex- 
pansion of the lungs and enables the 
patient to breathe more deeply and 
easily. If cyanosis is present, oxygen 
may be given nasally and continued 
until a good color can be maintain- 
ed without its use. Anything that 
seriously interferes with respiratory 
function will cause symptoms of dysp- 
nea and possibly cyanosis. It is im- 
portant to remember that these are 
symptoms only and that the thing to 
do is discover the cause and correct 
it rather than to blindly administer 
oxygen to alleviate the symptoms. 

The maintenance of a clear tracheo- 
bronchial tree by an energetic cough 
routine, aided when necessary by inter- 
costal nerve block when pain is an 
inhibitory factor, is an important step 
in maintaining aeration of the lung. 
When the airway is not cleared by 
these methods, tracheal aspirations 
should be used. Postoperative bronchos- 
copy should not be delayed if these 
measures have failed. When the tracheo- 
bronchial tree is being flooded with 
secretions and tracheal aspirations have 
to be repeated frequently, the patient 
can be managed far better by a prompt 
tracheotomy. This is a postoperative 
aid that should not be held in abey- 
ance as a last resort, but should be 
used more promptly. Sedation is kept 
at a minimum to ensure prompt co- 
operation in the cough routine. 

A nurse is present almost con- 
tinuously at the patient's bedside for 
24 hours to give him constant nurs- 
ing care and to be immediately aware 
of any change in his condition, should 
it occur. To encourage coughing, deep 
breathing and adequate drainage of air 
and fluid from the involved thorax, 
the patient is stimulated to turn from 
side to side hourly when awake. There 
is no contraindication to turning onto 
the operative side provided the drain- 
age tubes are not compressed. In 
pulmonary surgery, early active move- 
ment, adequate and proper physio- 
therapy and early ambulation are 
potent factors in ensuring minimal 
complications and a speedy recoAery 
from the disturbed pulmonary physi- 
ologv and trauma. 



A complete bed bath is given and 
the linen changed during the afternoon 
of the operative day. Antibiotics are 
given as ordered. Analgesics are ad- 
ministered in doses adequate to relieve 
pain and apprehension, but care must be 
taken to maintain a level of conscious- 
ness which allows for cooperation in 
coughing and deep breathing. Arm 
and leg exercises are started the even- 
ing of the operative day and the physio- 
therapist assists with the breathing and 
coughing as taught preoperatively as 
soon as the patient's consciousness and 
condition warrant it. One of the great- 
est measures of help a nurse can give 
to a patient after a thoracotomy is to 
regularly support his wound with her 
hand and encourage him to produce 
an effective expulsive cough. The sup- 
port diminishes the pain the patient 
experiences with this mechanism. At a 
later stage, the introduction of a large 
folded bath towel around the chest 
so that the patient may grasp both 
ends anteriorly and exert counter pres- 
sure over the wound is a useful ad- 
junct to produce an effective cough. 

Fluids are given as tolerated if there 
is no nausea and diet is increased as 
rapidly as the patient desires. In the 
immediate postoperative period, one 
should watch for gastric distention. 
It is important to realize that disten- 
tion, especially when marked, greatly 
interferes with cardiac action and de- 
creases pulmonary ventilation. The 
most common finding is a rapidly rising 
pulse rate and eventual hyperpnea. 
Prompt decompression is necessary. 
The use of a Levine tube relieves a 
doubly embarrassed system. A record 
of the fluid intake and output is kept 
for at least three days. Vitamin therapy 
is resumed as soon as the patient is on 
oral intake. 

The blood pressure, temperature, 
pulse and respirations are taken every 
four hours for the first two days. Then 
the blood pressure is checked daily, 
as required. The temperature, pulse and 
respirations are taken three times a 
day until discharge. A portable chest 
x-ray, with the patient sitting upright, 
is taken on the first morning post- 
operatively and again on the second 
or third days postoperatively. When 
the lung has re-expanded and become 
adherent to the chest wall, providing 
fistulae are not present, the drainage 



220 



THE CAN'.ADIAN NURSE 



tubes are removed. This state is in- 
dicated by the chest x-ray and by the 
failure of the column of fluid in the 
underwater drainage tubes to fluctuate 
with respiration and coughing. The 
tubes are removed usually on the 
second or third postoperative day with 
precautions taken to avoid letting any 
air into the chest by tightening a pre- 
viously placed suture. The stab wounds 
are sealed ofT with an air-tight dress- 
ing for at least 48 hours. A chest 
aspiration may be done later to with- 
draw any excess fluid or air which may 
have accumulated after removal of 
drains. A hemoglobin and hematocrit 
check is done on the first, second and 
fifth days postoperatively to determine 
the blood balance. 

To loosen bronchial secretions, steam 
inhalations are given for 20 minutes 
three times daily in addition to the 
continuous steam provided by the kettle 
at the bedside. Sputum liquifiers, such 
as Alevaire may be given by using an 
aerosal nebulizer and potassium iodide 
may be given orally. The use of "cough- 
alators" and positive pressure breath- 
ing apparatus may also be employed 
to assist those patients who are not 
coughing and breathing effectively. 

The patient receives a complete bed 
bath for the first few days postoper- 
atively and special back and mouth care 
is given every two hours when the pa- 
tient is awake. As his condition im- 
proves, the patient is encouraged to be 
up increasingly with assistance and to 
assume more responsibility for his 
own body cleanliness and oral hygiene. 
He is usually ambulatory within a few 
days after operation. The sutures are 
removed about seven to ten days fol- 
lowing surgery. 

Additional care required for patients 
who have undergone cardiac or great 
vessel surgery includes a restriction of 
fluid intake to 1000-1200 cc, for an 
adult, for at least two days. A record 
is kept of fluid intake and output for 
five days postoperatively. Daily weights 
are recorded after the patient is ambu- 
latory, until his discharge from the 
hospital. The blood pressure, heart rate 
and regularity are recorded frequently. 
Again, the salt intake, digitalization 
and use of diuretics receive special 
attention. Usually ambulation is delay- 
ed in these cases as compared to pa- 
tients having had pulmonary surgery. 



In considering postoperative com- 
plications of thoracic surgery, it may 
be said that shock is somewhat more 
prevalent than in most operative pro- 
cedures. The most effective therapy 
to combat shock is the replacement 
of the deficiency in the blood volume. 
For this purpose the use of whole blood 
is ideal and is used whenever possible. 
The concentrated efforts of the patient, 
with the assistance of the nurses and 
physiotherapist, in keeping the bron- 
chial tree clear of secretions helps 
prevent atelectasis, which is one of the 
most common complications associated 
with thoracic surgery. 

A serious complication which may 
arise following a pneumonectomy is 
a bronchopleural fistula, which is a 
direct communication between the 
bronchus and the pleural cavity. It 
occurs when the suture line of the 
bronchial stump breaks down. Should 
this happen while the chest drainage 
tube is present, it is indicated by a 
rapid bubbling in the underwater seal 
drainage bottle. If, however, it occurs 
after removal of the drain, it is im- 
portant to establish underwater seal 
drainage as soon as possible, to prevent 
accumulation of air in the pleural 
cavity causing mediastinal shift, de- 
ficient heart filling and therefore 
lowered cardiac output and acute re- 
spiratory difficulty. The symptoms 
which may be present are : dyspnea, 
cyanosis, tachycardia, increased re- 
spiratory rate, shift of the trachea to the 
non-operated side and subcutaneous 
emphysema. The empyema which then 
follows may require thoracoplasty, in 
a pneumonectomy. The convalescence 
is prolonged and may be precarious. 

With good care before and after 
operation, the course of the person who 
has had major thoracic surgery should 
be no more turbulent than that of one 
undergoing any other major surgical 
procedure. It must be remembered that 
a patient having thoracic, and more 
particularly, cardiac surgery is in a 
disturbed state of mind. It has been 
shown that the incidence of the de- 
velopment of temporary minor or 
major psychoses after cardiac surgery 
is much higher than after general sur- 
gery. Therefore all measures should 
be taken to reassure the patient, to 
maintain an air of confidence and to 
explain, in simple lay terms, the object 



MARCH, 1959 • VOL. 55. No. 3 



221 



of the surgical procedure ; what it will 
accomplish and what he can expect 
postoperatively, always maintaining a 
positive and optimistic outlook. Ad- 
vances in surgical technique and anes- 
thesia have played a major part in the 
success of thoracic surgery, but the 



results are as much dependent upon 
intelligent and enlightened nursing care 
as on any other factor. If the few 
simple principles stated here are kept 
in mind, the thoracic surgical nurse 
will find that "All things are clear in 
the ligfht of reason." 



Skin Antisepsis 



Philip B. Price, M.D. 



A HIDDEN RESERVOIR of bacteria exists 
somewhere deep in the human skin. 
The precise location and quantity of 
these "deep bacteria" are as yet un- 
known but appreciable numbers of 
them begin to appear in washings of 
the skin after 10 to 15 minutes of 
scrubbing. This strengthens the theory 
that it is impossible to kill or remove 
all germs in the skin without destroy- 
ing the skin itself. 

Both "transient" and "resident" 
germs are found on the surface of 
our bodies. "Transients" vary tremen- 
dously in number and in kind. For- 
tunately for the health of man, most 
of the extraneous microorganisms that 
get on his skin soon disappear. Some 
die ; others fall off, are rubbed off 
on clothes or are washed off. In 
general, transient bacteria are more 
abundant on exposed skin, but enor- 
mous numbers of them collect under 
the nails, between the toes or where- 
ever there is protection. It takes from 
one to eight minutes of washing with 
soap and water to remove all transients 
from the hands and arms. They can 
be killed with relative ease by chemical 
disinfectants. 

"Residents" form the stable bacter- 
ial population of the skin. They live, 
multiply and die there. Inasmuch as 
resident bacteria are firmly attached 

Dr. Price, who is Dean of the Univer- 
sity of Utah College of Medicine, 
delivered an address on this subject as 
part of a series of lectures sponsored by 
Becton, Dickinson and Company and 
Seton Hall College of Medicine and 
Dentistry, Jersey City, NJ. 



to the cutaneous surface, washing 
removes them slowly. They are less 
susceptible than transients to the action 
of disinfectants. Residents are compos- 
ed largely of staphylococci of low 
pathogenicity, but a few Staphylococcus 
aureus and other pathogenic bacteria 
are almost always present. 

The primary purpose of a skin dis- 
infectant is to reduce effectively these 
bacterial populations. Other things are 
important — nontoxicity, stability, ease 
of application, inexpensiveness — but 
the prime requisite is disinfection of 
the skin. 

Various tests are used to evaluate 
disinfectants. The serial basin hand- 
washing test is the only test of skin 
disinfectant action that reproduces 
faithfully the conditions of actual use, 
that is capable of controlling all the 
variables, that eliminates with certain- 
ty the troublesome factor of bacterio- 
stasis and measures the effect of dis- 
infectants on the skin flora, quanti- 
tatively and qualitatively, with a fair 
degree of accuracy. The status of some 
common skin disinfectants follows : 
Ethyl Alcohol — For routine surgical 
use, 70% alcohol by weight is recom- 
mended for several reasons. It is some- 
what less expensive than the more con- 
centrated preparations. It wets the skin 
well, spreads smoothly, and evaporates 
slowly. It does not injure the keratin 
or extract the lipids of the epidermis, 
and in consequence is almost perfectly 
innocuous on the skin. 

Isopropyl Alcohol — It might well 
be substituted for ethyl alcohol in prepa- 
parations used to disinfect the field of 
operation, but it is not recommended 



222 



THE CANADIAN NURSE 



for routine preoperative preparation of 
the hands. 

Mercurials — The best of these so- 
lutions has been found to reduce the 
flora by less than half in three minutes 
but in general they are not easy to evalu- 
ate accurately or with assurance. 

Iodine — One or two per cent iodine 
dissolved in 70% alcohol is an excellent 
skin disinfectant. It spreads evenly, dries 
slowly, and evaporation does not leave 
a rim of concentrated iodine to burn the 
skin. Aqueous solutions of iodine should 
not be used on the skin, since they may 
cause severe burn and even iodism from 
absorption. 

Zephiran (Benzalkoniiim Chloride) — 
In vitro, zephiran is a powerful, rapidly 
acting germicide against test bacteria, 
but on the skin, under conditions of 
ordinary use, its disinfectant action is 
not as great as has been generally sup- 
posed. Hands and arms that have been 
scrubbed in the usual manner need to be 
very thoroughly rinsed with water (for 
one minute or more) in order to remove 
the soap which clings so tenaciously to 
skin and tends to neutralize the bacte- 
ricidal action of zephiran. Since solutions 
of alcohol are better soap solvents than 
water, it is recommended that the site 
of operation be washed alternately, sev- 



eral times, with 70% alcohol and tincture 
of zephiran. 

G-11 (Hexachlorophene) — It has 
been asserted that persons who operate 
regularly no longer need to scrub in the 
old-fashioned manner, nor soak their 
hands in disinfectant solution. Instead it 
is necessary only to lather their hands 
and arms for two or three minutes with 
G-11 detergent. As far as I can deter- 
mine, single periods of washing or scrub- 
bing for from one to ten minutes with 
preparations of G-11 in bar soap, liqu~1d 
soap, or Phisoderm, do not immediate- 
ly reduce the cutaneous flora any more 
rapidly than if the washing had been 
done with Ivory soap. Used rationally 
and faithfully, G-11 soap of G-11 Phiso- 
derm is probably capable of contribut- 
ing materially to the perfection of aseptic 
surgical technique. In my judgment it 
should not be employed to the exclusion 
of the conventional preoperative scrub 
or the customary chemical disinfection 
of hands and the field of operation. It 
seems to me that danger lies in the 
creation of an unwarranted sense of 
security in the minds of those who 
choose to believe that a single, short, 
timesaving wash with a G-11 detergent 
can be depended upon to disinfect the 
skin. 



Red Cross Fellowship 



FOR THE PROFESSIONAL NURSE who is pre- 
pared to undertake special graduate study 
in a specific field such as research, general 
education, social work or hospital archi- 
tecture, assistance is now available. 

The qualifications of candidates should 
include professional maturity, registration 
in Canada, a baccalaureate degree and pro- 
fessional experience covering a period of not 
less than five years. Preferably, the prepa- 
ration sought should be for a specific posi- 
tion available and accepted by the candidate. 

The amount of the bursary will be related 
to the needs of the candidate. It is hoped 
that an annual grant can be added to the fund 
and that the total amount accruing will be 
the limiting factor in relation to the degree 
of support, the length of study and the fre- 
quency of the award. 



Enquiries should be directed at an early 
date to the National Director of Nursing 
Services, Canadian Red Cross Society, 
95 Wellesley St. E., Toronto. 



The little fisherman on our cover picture 
is Philip Little, the 1959 National Easter 
Seal Child for the United States. The annual 
campaign here began on February 27 and 
will continue until March 29. The funds 
from the sale of seals will ensure continu- 
ing care for children crippled by cerebral 
palsy, poliomyelitis, accidental injury and 
other conditions. Programs of research and 
study will give each child a better oppor- 
tunity for successful rehabilitation. 



MARCH, 1959 • VOL. 55. No. 3 



223 



RfSfflRCH 



The leed for Research in Nursing 



Nettie D. Fidler, B.A. 

A Profession and its Hallmarks 

PROFESSIONS have as their primary 
objective service to man and so- 
ciety. For this purpose they are 
measured by certain criteria which are 
appHcable to them all. There is, of 
course, the application of their knowl- 
edge in services which are vital to 
human and social welfare. They attract 
individuals who place service above 
personal gain and who regard their 
occupation as a life work. In these 
ethical and social fields it appears that 
nursing is acknowledged to be pro- 
fessional. In fact it has been said that 
no other professional group has a 
higher concern for the welfare of its 
clients. 

There are, however, certain other 
criteria. A profession bases its practice 
on a well-defined and extensive body 
of knowledge on the level of higher 
learning. Closely related to this, it 
constantly enlarges this body of knowl- 
edge by the use of the scientific 
method. In other words it grows in 
competence by research. 

Nursing has very good friends in 
other professions. All seem to regard 
nursing as essential; all try to make 
constructive suggestions ; all point out 
the need for research, but all question 

Miss Fidler, who is the director of 
the School of Nursing, University of 
Toronto, prepared this article as the 
first in a series to be devoted to the sub- 
ject of research in nursing. 



224 



the body of knowledge, especially in 
science. We have all read recently the 
work of Esther Lucile Brown, of Mar- 
garet Bridgman, of the Ginsberg Com- 
mittee. I would like to go back a little 
and quote from another person inter- 
ested in nursing, writing exactly 20 
years ago. Dr. H. B. Atlee of Dalhousie 
University says : 

It seems to me that if your profession 
is to inherit the place in the medical sun 
which it deserves it must somehow en- 
hance its prestige . . . Faced by the alter- 
natives of either struggling for improve- 
ment within your present limitations or 
setting yourself a new goal, I believe 
you must choose the latter ... (By this 
I mean) that you should become more 
professionalized . . . As I see it, a pro- 
fession is a group of trained workers 
which has within itself the capacity 
for making a more and more specialized 
contribution to human welfare . . . The 
professional worker creates his own 
world. The worker in a shoe factory is 
given a shoe to make, of which the pat- 
tern is very clearly laid down. But the 
doctor is given a sick body to deal with 
and in the handling of the problem he 
creates a whole new world of anatomy, 
physiology, physical and mental therapy, 
and prevention. On the basis of that 
definition I do not think it can be truly 
said that nursing is yet a real profession. 
Too much of the pattern you follow has 
been imposed on you from without — 
from my own profession, for instance — 

THE CANADIAN NURSE 



and not enough is created within yours. 
So the goal I would Hke to see you 
set yourselves is one towards which 
you will move more and more through 
your own initiative and resource. 

... I see no reason why the nurses 
of the future should not carry out nurs- 
ing research. If my profession is given 
facilities for the purpose why should 
yours be denied them? The only rational 
basis of denial would be that there is no 
longer room for improvement in nurs- 
ing — which is ridiculous. 
He goes on to say that nurses will 
have difficulties in gaining these facili- 
ties — difficulties created within their 
own ranks and from the medical pro- 
fession. "... I and my confreres will 
maintain stoutly our right to the sole 
overlordship of the medical world." 

The Problems of Nursing 

We have seen that friendly critics 
urge research as necessary to a pro- 
fession and to professional prestige. 
The real purpose of this is to improve 
nursing — • to find answers to the un- 
solved problems which have been mul- 
tiplying ever more rapidly in recent 
years. Examples of these problems are : 
the form or forms that nursing edu- 
cation should take ; the best use of the 
nurse's time and skill in the hospital 
and public health fields ; the use of the 
nursing team ; relationships with other 
health professions ; the formulation of 
a nursing science ; and above all the 
direct nursing of patients. 

These are examples taken at ran- 
dom. Some of them are so large that 
they would need to be divided for 
study. The profession is aware of these 
problems, and in Canada (as in Britain 
and the United States) there have been 
the beginnings of research on them. 
In this country we may cite the study 
which led to the reorganization of the 
Canadian Nurses' Association ; the 
Canadian Nurses' Association's demon- 
stration school of nursing at Windsor, 
Ontario ; the study of nursing educa- 
tion in New Brunswick ; the study of 
the functions and activities of head 
nurses made by the Research Division 
of the Department of National Health 
and Welfare in cooperation with the 
Canadian Nurses' Association ; and the 
cost study of basic nursing education 
programs in Saskatchewan. 



Participation in Research 

Although all nurses cannot and will 
not carry on major research projects, 
we all need to have a clear idea of the 
research process, of the "research ap- 
proach," and of the basic concepts of 
statistics because: 

1. We are all consumers of research 
and of statistics. We should be able to 
understand and evaluate the research of 
others. 

2. Many nurses, not primarily interest- 
ed in research, have immediate concrete 
problems of nursing, of administration 
or of education which have to be solved 
today. The regular steps used in re- 
search are applicable to any such prob- 
lem and will provide the best solution. 

3. This understanding is also useful 
in the assistance in medical research 
projects for which nurses are sometimes 
asked. 

The Role of the University in 
Research 

The functions of the university are 
often described briefly as teaching and 
research. All teachers must do research 
in connection with their teaching if it 
is not to become static. Some give a 
large part of their time to research. 
The undergraduate student does not do 
research in the full sense of the word. 
Nevertheless, it is in the undergraduate 
program that the foundations are laid 
for the research he may undertake later 
as a graduate. 

It has always been accepted that 
one of the results — perhaps the chief 
result — of a university education 
should be a "trained mind." It is as- 
sumed that thinking ability is actually 
improved and increased. This "train- 
ing" is not simply a matter of furnish- 
ing the mind with existing knowledge, 
important though this is. It is above all 
not a rigid conditioning to the past 
and to conservatism. The result desired 
is a disciplined and free mind. The 
subjects are liberalizing in themselves, 
but liberal teaching is necessary for 
their full effect. Thus the spirit of 
curiosity and inquiry should be given 
free rein from the beginning, while 
gradually the student's thinking be- 
comes more responsible and more sub- 
jected to the test of evidence and to 



march, 1959 • VOL. 55, No. 3 



225 



logical ordering — in short, a research 
attitude is developed. 

This type of teaching and learn- 
ing is not confined to universities. 
It can be, and indeed it is, used by 
good teachers in every type of pro- 
fessional or academic school. This is 
desirable from every point of view. 
In relation to the promotion of re- 
search in nursing it is essential, for our 
greatest obstacle is lack of trained 
personnel. This obstacle will not 'be 
removed until schools offering the 
basic nursing program liberalize their 
teaching so as to inspire and enable 
many students to proceed at least to 
their bachelor's degree, which is now 
generally recognized as the basic quali- 
fication for a research worker. 

The training of the research worker 
is, of course, the direct problem of 
the university schools of nursing and 
will require great effort on their part. 
The universities cannot lower the 
standards of their graduate degrees 
to accommodate nursing, nor would 
this be desirable. If nursing is to pro- 
gress as a profession its degrees must 
be comparable academically with the 
best degrees in any field. Our greatest 
difficulty is to find staff members with 
broad liberal backgrounds and with 
graduate degrees who are capable of 
building up the teaching and research 
programs of our schools to true gradu- 
ate level. 

Our second problem is to begin re- 
search programs here and now with 
such staff and facilities as we have 
at present in order to create a field 
into which students may be introduced. 
The solution of both these problems is 



dependent, to a large extent, upon our 
ability to interpret our needs to the 
administrators of our universities. 

If this task of interpretation is to 
be accomplished, the profession must 
be united with us in its desire for 
graduate programs that would make 
research in nursing possible. The 
Canadian Conference on Nursing, con- 
vened by the Canadian Nurses' Associ- 
ation in 1957, went on record as urging 
the need for graduate work. Do nurses 
as a whole agree with them? Can we 
assert confidently that the great major- 
ity of practising nurses think this 
matter urgent because they find that 
they need the kind of research which 
the university should provide ? 

We know that the idea of nursing 
research is young, but certainly there 
seems to be much interest and dis- 
cussion of it now. In our own small 
efforts at the University of Toronto 
we have not found the attitudes which 
Dr. Atlee feared. We have had un- 
stinted cooperation and collaboration 
from the nurses whose fields are in- 
volved. This did not really surprise 
us, though we knew they were very 
busy. What has surprised us, I think, 
is the interest shown by the doctors 
in these fields. We saw no sign of 
a desire to retain "the sole overlord- 
ship of the medical world." 

And so, though there are many ob- 
stacles and difficulties in the way, I 
cannot but feel that if we truly want 
research in nursing we will have it. 
For, to return to Dr. Atlee : "It is an 
historical fact that in preparing him- 
self for a better future, mankind has 
invariably created that future." 



Alumni of Teachers College, Columbia 
University, will attend a celebration late this 
spring commemorating the 100th anniversary 
of the birth of M. Adelaide Nutting, nursing 
education pioneer, and the 60th anniversary 
of the founding of the college's Division 
of Nursing Education. The celebration will 
be held May 15 and 16, 1959. 

There will be a dinner on the night of 
May 15. On May 16, an all-day meeting will 
be held at Teachers College. The meeting 
will focus on Miss Nutting's leadership in 
setting the foundation for nursing education 



in the United States and abroad, and on the 
future of nursing education. 

* * * 

Over 800 registered nurses serve as volun- 
teer instructors of the Canadian Red Cross 
Home Nursing Courses in communities 
throughout the nation. 

* * * 

The aim of reading ... is gradually to 
create an ideal life, a sort of secret, pre- 
cious life, a refuge, a solace, an eternal 
source of inspiration in the soul of the 
reader. — Arnold Bennett 



226 



THE CANADIAN NURSE 




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MARCH, 1959 • VOL. 55, No. 3 



227 



line Froctuense Pratique 



SoEUR Mance Decary 



LJassemblee annuelle du nursing 
est la reunion de tout le personnel 
professionnel du nursing et ses invites 
qui sont les autorites de I'Hopital, les 
medecins, les internes, les chefs de ser- 
vice des departements auxiliaires et de 
representantes de I'Association des In- 
firmieres de la Province de Quebec. 

Le but de cette reunion annuelle 
est d'informer chacune du travail ac- 
compli dans les differentes sections du 
departement du nursing au point de 
vue du service des malades et de I'edu- 
cation, de faire des recommandations 
et de proceder a I'election des membres 
des differents comites du nursing. 

L'idee de convoquer une assemblee 
annuelle du nursing a I'Hopital Notre- 
Dame est venue a la suite de I'organi- 
sation scientifique du service du nurs- 
ing qui date de 1951. Le service du 
nursing suit un plan d'organisation 
bien defini qui est explique par un dia- 
gramme precis. L'evaluation du per- 
sonnel necessaire, tant professionnel 
qu'auxiliaire, pour assurer des bons 
soins aux malades est basee sur les 
heures de nursing requises par jour. 
Ce calcul est possible grace a la feuille 
de repartition du travail que les res- 
ponsables des departements completent 
pour une periode de 24 heures, une 
fois la semaine, et qu'elles versent en- 
suite au secretariat du nursing oij la 
compilation est faite. Afin de faciliter 
le travail et de le standardiser tout en 
ameliorant constamment le soin des 
malades, nous avons prepare : 

1. Le manucl du service du nursing, 
instrument de travail qui presente les 
notions essentielles de I'organisation de 
ce service dans le but d'instruire le per- 
sonnel de ses obligations et de lui facili- 
ter I'observance des reglements de I'hopi- 
tal. Ce manuel traite des attributions 
du personnel, des conditions de travail 
et des directives au personnel, directives 
concernant les malades. 

2. Le cahier de relations inter-depar- 
tementales qui explique toutes les for- 



Soeur Decary est la directrice du nurs- 
ing a I'Hopital Notre-Dame, Montreal. 



mules employees dans I'hopital et la 
fagon de proceder pour obtenir un service 
des autres departements. 

3. Le manuel de techniques en nurs- 
ing revise chaque annee. 

4. Un systeme de dossier permanent 
pour chacune des infirmieres a I'emploi 
de I'hopital. 

5. Un inventaire perpetuel du materiel, 
prepare et revise tous les mois d'une 
fagon plus ou moins elaboree. 

6. Un budget quant aux item "sa- 
laires" et "materiel" alloue pour le nurs- 
ing. 

7. Les comites suivants ont ete formes 
et fonctionnent effectivement : 

Le Comite Executif du Nursing, le 
Comite de Regie de I'Ecole, le Comite 
Conjoint du Nursing, le Comite du 
Nursing et de la Pharmacie, le Comite 
d' Admission des Eleves a I'Ecole, le 
Comite d'Admission aux Cours Post- 
Scolaires, le Comite du Curriculum, 
le Comite de la Recherche en Nursing, 
le Comite d'Organisation du Travail 
d'Equipe, le Comite du Service Prive, 
le Comite d'Etudes des Techniques 
Theoriques et Pratiques. 

8. Des assemblees frequentes avec les 
hospitalieres servent de moyen de com- 
munication entre tous les membres pro- 
fessionnels et auxiliaires de notre service. 

9. Un programme educationnel a ete 
elabore. II se divise en trois parties : 
orientation, enseignement sur place, en- 
seignement continu. 

Apres avoir etabli toutes ces bases, 
nous avons pense que revolution du 
nursing devait etre soulignee car mal- 
heureusement, beaucoup trop souvent, 
on ignore ce qui se deroule dans une 
institution de I'ampleur de la notre. 
Nous avons cru que les autorites de 
I'hopital et les infirmieres seraient in- 
teressees a prendre connaissance de tout 
le travail qui se fait dans les differents 
departements du nursing, de meme que 
des statistiques assez completes que 
nous etions en mesure de presenter. 

C'est alors que nous avons tente 
d'inaugurer en 1953, notre premiere 
assemblee annuelle du nursing sous 
la presidence d'honneur conjointe de 



228 



THE CANADIAN NURSE 



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NAME. 



CITY PROV. 



MARCH, 1959 • VOL. 55, No. 3 



229 



Soeur Denise Lefebvre, directrice de 
rinstitut Marguerite d'Youville, et de 
Mile Suzanne Giroux, visiteuse ofifi- 
cielle des ecoles d'infirmieres. 

Les rapports presentes a cette as- 
semblee par les Religieuses et infirmie- 
res responsables des departements sont 
les suivants : 

Section de I'Education, Section des 
Activites Scolaires, Service des Malades : 
education, personnel, organisation, rap- 
ports du service de nuit, salles d'ope- 
rations et de reveil, oxygenotherapie, 
cliniques externes, deux ou trois rap- 
ports des differents services des depar- 
tements des malades. 

Afin de souligner I'importance du 
travail en comitcs et le resultat obtenu, 
la lecture est faite des rapports des co- 
mites : 

Comite du curriculum, des techniques 
theoriques et pratiques, du service prive 
et du comite Conjoint du Nursing, etc. 



A Tissue de cette premiere assem- 
blee annuelle, les infirmieres ont mani- 
feste un tel enthousiasme a la revela- 
tion du travail effectue dans le service 
du nursing depuis son organisation, 
qu'elles ont manifeste le desir qu'une 
reunion semblable soit tenue annuelle- 
ment. 

Cette recommandation a ete suivie 
et depuis, chaque annee, nous avons 
eu des assemblies similaires sous la 
presidence d'honneur de differentes 
personnalites. Apres chacune de ces 
assemblees, tous les rapports sont im- 
primes et adresses aux administrateurs 
de I'hopital, aux chefs des services, 
aux medecins qui sont membres du 
Comite Conjoint du Nursing, et aux 
infirmieres a titre d'information et de 
references, particulierement pour les 
personnes qui n'ont pu assister a I'as- 
semblee a cause de leurs heures de 
service. 



ENr.LISH OK FRENCH? 



Everyone is aware by now of the fact that 
two separate issues of our Journal will be 
published each month commencing with the 
June, 1959 number. This important milestone 
in the history of the nursing profession in 
Canada will be marked by several changes. 
A sihart new cover design for both issues has 
been approved. We are departing from the 
dark blue color on the cover that has identi- 
fied our Journal for the past 20 years. 

Arrangements have been made respecting 
publication dates. The Canadian Nurse, as 
the senior issue, takes precedence. It will 
come from the press at the beginning of the 
month. L'Infirmiere Canadicnne will follow 
in approximately ten days. 

Currently, the separate mailing list for 
those who desire to receive the French issue 
is being built up. The A.N.P.Q. is helping 
us very materially by indicating with an as- 
terisk those of its members who are English 
and who will, therefore, be put on the mail- 
ing list for The Canadian Nurse. All other 
subscribers in the province of Quebec will 
automatically be placed on the list of those 
who will receive the French issue. Any 
among the latter group who wish to receive 
the English issue instead are requested to 



230 



notify the Journal office in writing before 
April 15, 1959. Please give us your registra- 
tion number as well as your full name and 
address to avoid the possibility of errors. 

Similarly, L'Infirmiere Canadienne will 
be available to any subscriber who wishes 
to receive the Journal in French. All that 
will be necessary is to notify us in writing, 
again giving the essential information for 
identification purposes : Your name, address, 
province of registration and registration 
number. 

Of course, changes can be made later at 
any time. But every nurse who wishes to 
make a change in the above-mentioned listing 
must notify us by April 15, 1959 if she 
wishes to receive the June issue. 

Su^h changes zvill only be made when they 
are requested in writing. The address to 
which all of these letters should be sent is : 
The Canadian Nurse Journal, 
1522 Sherbroolie Street West, 
Montreal 25, Quebec. 



I enjoy convalescence. It is the part that 
makes the illness worth while. 

— G. B. Shaw 

THE CANADIAN NURSE 



HIGHLY EFFECTIVE 

AGAINST STAPHYLOCOGGI 

...YEAR AFTER YEAR 



CHLOROMYCETIN 

IN VITRO SENSITIVITY OF STAPHYLOCOCCI FROM THREE FOCI OF INFECTION TO CHLOROMYCETIN FROM 1953 TO 1957* 

JANUARY-JUNE. 1957 

DBSHI^IIIi^lilHIIJJIJU^I^I^^IimJIH ^^-^^ 

. I^^HHIIB^^H^IIBIHIH^IH 86.9% 
respiratory ■■■■■^■^■■^■■■^■^^■■■■l^i^HHH^Hi^HHHHiH^H 

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^H 97.5% 



OCTOBER, 1955-MARCH, 1956 



Skin 



Upper 
respiratory 




JUNE-DECEMBER. 1953 



Slin 



Upper 

respiratory 

Car 




•Adapted from Royer, A., in Welch, H., & Marti-Ibaiiez, E: 
Antibiotics Annual 1957-1958, New York, Medical Encyclopedia, Inc., 1958, p. 783. 

CHLOROMYCETIN (chloramphenicol, Parke-Davis) is available in a 
variety of forms, including Kapseals® of 250 mg., bottles of 16 and 100. 
CHLOROMYCETIN is a potent therapeutic agent and, because certain 
blood dyscrasias have been associated with its administration, it should 
not be used indiscriminately or for minor infections. Furthermore, as 
with certain other drugs, adequate blood studies should be made when 
the patient requires prolonged or intermittent therapy. 

PARKE, DAVIS & CO., LTD. • TORONTO 14, ONTARIO: 



m 



MARCH, 1959 • VOL. 55, No. 3 



231 



Irsing Profiles 



As the federal government plan for hos- 
pitalization is accepted and set up in the 
various provinces, a pattern is evolving 
whereby a nurse consultant is appointed by 
the individual Hospital Services Commission. 
In New Brunswick Doris M. Grieve has 
been selected to fill this position. 




Doris Grieve 

Born in New Brunswick, Miss Grieve re- 
ceived her early education there and later 
attended the Normal School (now Teachers' 
College) in Fredericton. After teaching 
school for a number of years her interest 
turned to nursing. She is a graduate of 
Ottawa Civic Hospital and has had post- 
graduate preparation in teaching and super- 
vision at McGill School for Graduate Nurses. 
Miss Grieve has had considerable experience 
in administration in the fields of nursing ser- 
vice and nursing education. Until accepting 
her present appointment she was in charge 
of the nursing education program of Saint 
John General Hospital. 

Dorothy A. Potts was appointed the 
second nursing adviser to the WHO Re- 
gional Director of the Eastern Mediter- 
ranean Region late last year and has taken 
up her new duties in Alexandria, Egypt. 

A graduate of Moose Jaw General Hospi- 
tal, Miss Potts secured her baccalaureate 
degree in nursing before joining the staff of 



232 



Toronto General Hospital where she held 
the position of surgical supervisor 1947-1949. 
She resigned to become the director of nurs- 
ing at Belleville General Hospital where she 
remained until joining WHO in 1952. Her 
first assignment was to Dacca, East Pakis- 
tan as leader of a team of three nurses con- 
cerned with the development of a basic school 
of nursing. In 1957 Miss Potts was granted 
leave of absence to take advantage of a 
Kellogg Fellowship award and further study. 
She obtained her Master's degree in consul- 
tation in public health during this time. 

Immediately prior to her present assign- 
ment Miss Potts was in Singapore where 
WHO has been assisting with the improve- 
ment of nursing services — nursing edu- 
cation, midwifery and public health. She was 
responsible for planning and conducting pro- 
grams in ward administration and clinical 
teaching. As opportunities arose she also 
participated in programs for hospital matrons 
or directors of nursing service. In her present 
capacity she will undertake the responsibility 
of giving technical advice for the planning 
and coordination of the regional nursing 
program of WHO. She will advise and assist 
national health administrations with the 
development of their nursing and midwifery 
services and selection and training of per- 
sonnel. She will also participate in nursing 
studies as a basis for long-range planning. 

The announcement of the appointment of 




Sister Catherine Gerard 

the canadian nurse 



Sister Catherine Gerard as a member of 
the Royal Society of Health, London, Eng- 
land was received recently. This honor was 
bestowed upon her by reason of her contri- 
bution to nursing education and hospital ad- 
ministration and her colleagues and friends 
in nursing will agree that it is well deserved 
recognition. 

A graduate of Hamilton Memorial Hospi- 
tal, now St. Elizabeth Hospital, North 
Sydney, N.S. she studied at Saint Louis 
University, Missouri to obtain her certificate 
in hospital administration. Beginning her 
association with Halifax Infirmary as a 
general staff nurse, her administrative ability 
was soon recognized and Sister Gerard as- 
sumed positions of progressive responsibility. 
She is now the administrator of Halifax 
Infirmary. 

This fall the university of New Brunswick 
will open the doors of its new school of 
nursing. Ryllys Mae Cutler has been ap- 
pointed assistant professor and consultant in 
psychiatric nursing. 

A graduate of Royal Victoria Hospital, 
Montreal, Miss Cutler also holds her degree 
in nursing from McGill University and has 
had extensive preparation and experience in 




(Rice, Montreal) 

Ryllys M. Cutler 

psychiatric nursing at the Provincial Mental 
Hospital, Essondale, B.C. For the past year 
she has been a member of tlie NBARN 
provincial office staff and has had the re- 
sponsibility of conducting various nursing in- 
stitutes and follow-up programs. 

Late last fall Gertrude Dallaire was ap- 
pointed chief nurse with the City Health De- 
partment, Montreal. A native of Quebec, she 




(Garcia Studio — Montreal) 

Gertrude Dallaire 

is a graduate of St. Justine's Hospital, class 
of 1933. 

After spending several months in the 
medico-social department of her home hospi- 
tal, she joined the staff of the Alontreal 
Children's Hospital in 1935 and during the 
next seven years served successively as a 
general duty nurse, head nurse and assistant 
superintendent. In 1942 her association with 
the City Health Department began. 

Study in public health nursing at the 
University of Montreal was followed, in 1953, 
by further postgraduate preparation at 
Teachers College, Columbia University where 
she obtained her Bachelor of Science degree 
and in 1954, her Master's degree, major- 
ing in administration in public health nursing. 

In 1951 Miss Dallaire was made a super- 
visor in the City Health Department and in 
1954 she became an assistant chief nurse. 
In 1949 her services to the City were inter- 
rupted briefly when she went to Haiti to 
work on a pilot project in education under 
the auspices of UNESCO and WHO. She 
enjoys travel and this particular assignment 
combined work and pleasure. Completely 
bilingual, she enjoys reading, attends the 
theater as often as possible, and indulges 
in more travel when the opportunity presents 
itself. 

This is a tribute to one general duty 
nurse but also, albeit indirectly, to the 
many others of her sisters in the nursing 
profession engaged in similar activity who 
may sometimes feel that their role is accord- 
ed little recognition. 



MARCH, 1959 • VOL. 55, No. 3 



233 



Presently on duty in Montreal's Notre 
Dame Hospital is a Scottish Canadian 
graduate of that institution, class of 1912, 
Rosalie Dunn. Miss Dunn returned to 
general duty 10 years ago after 20 years of 
experience as nurse-inspector with the Me- 
tropolitan Life Insurance Company of Mont- 
real, six years as director of nurses at Hopital 
Bourgeois, Three Rivers, P.Q. and a similar 
length of time specializing in surgery in her 
home hospital. Her particular concern now is 
the patients admitted for neurosurgical treat- 
ment. She does not confine her interest to 
the hospital situation alone but in true appli- 
cation of "total patient care," she extends 
her services to the patient's family through 
understanding counsel and practical help in 
adjusting to the problems encountered in 
conditions involving the nervous system. 

The wisdom of years of experience in her 
profession — both in the community and in 
the hospital — have given her the insight 
to recognize that your job, in many ways, 
is as interesting and as satisfying as you 
make it. It can be a daily routine of tasks 
performed efficiently but flavored with mon- 
otony and without recognition of the inherent 
implications or it can be a daily adventure 
spiced with the warmth of human relation- 
ships as the total picture is appreciated. Miss 
Dunn has demonstrated the latter course in 
an exemplary way. 

Isabel Lane, the school of nursing ad- 
viser for the province of New Brunswick 
since 1951, has had to terminate her duties 
for personal reasons. Her resignation is a 
cause for sincere regret by the NBARN and 
the schools of nursing in the province. 

Her personal concern for and interest 
in the student nurses and the very excellent 
rapport that she established with those re- 
sponsible for the administration of the schools 
assured the success of the project. Miss Lane 




Isabel Lani: 

became the province's first school of nursing 
adviser in May, 1951 when the position came 
into being with the support of a Federal- 
Provincial grant. When the grant terminated 
last year the schools of nursing were so 
emphatic in their desire to have the service 
continued that the provincial association 
undertook financial responsibility for it. 

A graduate of Montreal General Hospital 
with postgraduate preparation in tuberculosis 
nursing and in teaching and supervision in 
schools of nursing, Miss Lane has had ex- 
perience both in the institutional and public 
health fields prior to her advisory capacity. 
She will be greatly missed by those who 
worked with her and sought her counsel. 

Laura Vrooman who has been in the 
service of the Ontario government since 1920 
retired in December of last year. She was 
one of the first public health nurses ap- 
pointed by the Bureau of Maternal and Child 
Hygiene under the provincial Board of 
Health. 

In 1944 Miss Vrooman became a member 
of the Public Health Education Section of 
the Ontario Department of Health and for 
a number of years was in charge of the 
publications put out by the department. 



A Memorial 



At the suggestion of many of her friends, 
a memorial at Blue Mountain Camp, Colling- 
wood, Ontario, is being planned for Gretta 
Mackay Ross, the first director of nursing 
and camps for the Ontario Society for 
Crippled Children. Blue Mountain Camp was 



the first of three camps opened and operated 
under Miss Ross' supervision. Those who 
may wish to add to the memorial fund can 
do so by sending their contribution to the 
Ontario Society for Crippled Children, 
92 College Street, Toronto. 



334 



THE CANADIAN NURSE 




stop Back-Breaking Bedsore Battles! 

APP Units Reduce Extra Nursing Care Up To 50% 

The Alternating Pressure Pad relieves the nurse of one of her most time-con- 
suming responsibihties . . . constant turning of patients who either have, or 
are candidates for, bedsores. By automatically shifting pressure points on the 
supporting areas of the body, as illustrated, the APP Unit in effect "turns" 
the patient every two minutes, preventing tissue breakdown and maintaining 
the adequate circulation necessary to prevent and heal bedsores. The combi- 
nation of an APP Unit and normal nursing care starts granulation usually 
within a few days. 

Thousands of APP Units are now in use. Many more are needed for private 
patients, in hospitals and nursing homes. Units are available from leading 
surgical supply houses for standard beds, respirators and wheel chairs. 




APP Units are manufactured solely by Air Mass, Inc., Cleveland, Ohio, U. S. A. 



MAIL THIS COUPON FOR ACTION 



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5135 de Gcispe St. 

Montreal, Quebec. 

Q Please send complete details on APP Units. 

D Please send APP Unit Clinical Rejxjrts. 

n Please have your representative call me to arrange a demonstration. 



Institution. 



Street- 
City 



_Zone- 



-State- 



Requested by. 



MARCH, 1959 • VOL. 55, No. 3 



235 



KNOX GELATINE . . . 



a positive way 
to strengthen 




Nobody ever died of brittle fingernails. That's not to say that 
this all too common feminine problem has not caused much 
patient distress and even some professional perplexity. 

Happily a new prognosis is possible for better than seven out of 
ten women with brittle fingernails. One to three envelopes of 
Knox Gelatine a day for three months restore strength in 
approximately 80% of patients. ^'2. 3, 4 Improvement is usually 
apparent in 30 days. 

Adequate intake of Knox Gelatine (min. 1 envelope — 7 Gm. or 
120 grains per day) is absolutely essential to produce the Specific 
Dynamic Action necessary to correct the brittle nail defect. If you 
would like to examine at first hand the clinical research establishing 
this use of Knox Gelatine, just use the coupon below. 



KNOX GELATINE (CANADA) Ltd. 

Professional Service Department 
140 St. Paul St. West, Montreal, Quebec 

please send reprints oj the following articles: 

1. Rosenberg, S., Oster, K.A., Kallos, A. and Burroughs, W.: 
A.M. A. Arch. Dermat. 76:330, September 1957. 

2. Schwimmer, M. and Mulinos, M.G.: Antibiot. Med. & Clin. 
Therapy 4:403, July 1957. 

3. Rosenberg, S. and Oster, K.A.: Conn. State Med. J. 19:171, 
March 1955. 

4. Tyson, T.L.: J. Invest. Dermat. 14:323, May 1950. 

YOUR NAME AND ADDRESS 



KNOX 

UN FLAVORED 




ff 




^ 



i:. 
I 

I 
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3n ilemonam 



Dorothy (Armstrong, Shapter) Arnold, 

who graduated from the Hamilton General 
Hospital in 1934, died in January, 1959. She 
did public health nursing in Guelph, Chatham 
and the Elgin-St. Thomas Health Unit from 
which she resigned in 1948. 

* * * 

Bertha (Samson) Beck a graduate of 
Winnipeg General Hospital in 1917 died in 
October, 1958. Mrs. Beck served overseas 
with the Canadian Army Medical Corps in 

World War I. 

* * * 

Alice E. Bingeman, a graduate of Roose- 
velt Hospital, New York, died on June 6, 
1958. Following a short period spent in pri- 
vate nursing, Miss Bingeman joined the staff 
of Beck Memorial Sanatorium, London, Ont. 
Later she became superintendent of the Free- 
port Sanatorium, Kitchener, wliere she re- 
mained for 20 years until her retirement in 
1948. 

4< 4i ♦ 

Frances May (Duncan) Burridge, 

who graduated from Winnipeg General Hos- 
pital in 1902, died November 3, 1958. 

* * ♦ 

Jessie Gorden Campbell, a graduate of 
Toronto Western Hospital in 1917, died re- 
cently. At the time of her death she was 
engaged in private nursing. 

* * * 

Mary Palma Campbell, a graduate of 
the Infirmary and Fever Hospital and St. 
Mary's Obstetrical Hospital, Greenock, Scot- 
land, died in December, 1958. Miss Campbell 
joined the Vancouver School Board as a 
school nurse in 1918. In 1936 the Metropolitan 
Health Committee of Greater Vancouver was 
formed and she was appointed a nursing 
supervisor of one of the new health units. 
She retired in 1940. An active member of 
the RNABC, Miss Campbell was its presi- 
dent 1929-33. 

* * * 

Doris (Dafoe) Cooper, a graduate of 
a Winnipeg hospital, died in September, 1958. 

* ♦ ♦ 

Diane DufF who graduated from Toronto 
Western Hospital in 1958, died on January 
4, 1959 as the result of injuries received 
in a car accident. At the time of her death 
she was engaged in postgraduate study at the 
University of Western Ontario. 

* ♦ ♦ 

Mrs. Olga Duncan, a graduate of Van- 



couver General Hospital, died in Ventura, 
California in November, 1958. 

* * * 

Mona Elizabeth Easton who graduated 
from General Hospital, Brockville in 1949 
died on November 13, 1958 from injuries 
received in a car accident. She was on the 
operating room staff of the Ontario Hospital, 

Brockville at the time of her death. 

* * * 

Anne Agnes Garies who had spent 20 
years in nursing in Canada and the United 
States died in September, 1958 at Swift 
Current, Sask. 

* * * 

Florence Gibbons, a graduate nurse from 
England died on October 29, 1958 in Win- 
nipeg where she had nursed since coming 
to Canada. 

* ♦ * 

Jean (Taylor) Hallock who graduated 
from the Public General Hospital, Chatham, 
Ont. in 1920 died in October, 1958. 

* * * 

Frances Athil Harman who graduated 
from the Montreal General Hospital in 1909, 
died on September 15, 1958. She had served 
overseas with the Canadian Army Medical 
Corps in World War I. 

* * * 

Kathleen (Storozinski) Hopfner, a 

graduate of St. Boniface Hospital, Manitoba 
in 1956, died in October, 1958. She was on 
the staff of Johnson Memorial Hospital, 
Gimli, Man. at the time of her death. 

* * * 

Mary Constance (Partridge) Lee who 

graduated from Royal Victoria Hospital, 

Montreal in 1900 died in August, 1958. 

* * * 

Evelyn Lucie McElligott, a graduate of 
the Toronto General Hospital in 1936 died 
in October, 1958. 

* * * 

Jean Mary (Denovan) Norris a gradu- 
ate of Royal Jubilee Hospital, Victoria, died 
in August, 1958. She served overseas during 
World War I in England and France. 

* * * 

Etta Alice (Timleck) Putnam, a gradu- 
ate of Vancouver General Hospital in 1918, 
died in October, 1958. 

* * * 

Katherine Elizabeth (Underwood) 
Middleton, a graduate of an English hospi- 
tal who devoted her professional life to work 
among the Blood Indians, Cardston, Alta. 



238 



THE CANADIAN NURSE 




for complete protection during clnldbood 

Each daily dose from spoon or dropper supplies optimum amounts of 
A, D, C and the four principal B vitamins in a smooth palatable 
vehicle. Both forms mix readily with milk or cereal and are quickly 
absorbed. Easy to give, delightful to take, inexpensive, water-soluble 
Infantol Drops or Liquid means complete vitamin protection during 
the formative years. 

now dated and certified for added I t^ I C*\ n T C^ 
assurance of potency I I I I V^ ■ I ■ V/ 

DROPS / LIQUID 



FRANK 



W 



HORNER 



M I T E D 



MONTREAL 



CANADA 



MARCH, 1959 • VOL. 55. No. 3 



239 



died in August, 1958. She was matron of the 
Indian hospital for 21 years. 

Norena Sara Mackenzie who graduated 
from Montreal General Hospital in 1926 
died on January 13, 1959. At the time of her 




Norena Mackenzie 

death slie was the director of nursing and 
principal of the school of nursing of the 
Jewish General Hospital, Montreal. In 1945 
she was one of the Canadian nurses who 
went abroad to assist in the work of the 
United Nations Relief and Rehabilitation 
Administration. Miss Mackenzie served in 
Italy and in Germany where she developed 
an educational program for nursing assistants. 

* * * 

Gertrude May (Bellam) Reid who 

graduated from Souris Hospital, Man. in 
1924 died recently. 

* * * 

Ada (Newton) Renton who graduated 
from Winnipeg General Hospital in 1899, 
died in November, 1958. Under her guidance 
the alumnae association of the hospital was 

developed. 

* * * 

Mary M. Roberts, one of the outstanding 
nursing leaders of the twentieth century, 
died on January 11, 1959. To Canadian as 
well as to American nurses she will be best 
remembered as the distinguished editor and 
later, editor emeritus of the American 
Journal of Nursing. She was associated with 
this publication for a total of 38 years. 

Born in Cheboygan, Michigan, in 1877. 
Miss Roberts graduated from the Jewish 
Hospital Training School for Nurses, Cin- 
cinnati, Ohio in 1899. She secured her 
Bachelor of Science degree and her cer- 



tificate in administration of nursing schools 
from Teachers College, Columbia University. 
Hospital work in various capacities was 
succeeded by an appointment as director of 
the Bureau of Nursing, Lake Division of the 
Red Cross and then one in 1918 as director 
of a unit of the Army School of Nursing. 
Eventually she became chief nurse of the 
Army Nurse Corps, a position she held until 
her discharge from military life in 1919. In 
1921 Miss Roberts succeeded Miss Sophia 
Palmer, the first editor of the American 
Journal of Nursing. Under her skilful leader- 
ship the Journal experienced a tremendous 
growth in scope of interest and circulation. 

In 1949 Miss Roberts retired as editor 
and became editor emeritus — a change that 
gave her the opportunity to maintain her 
contact with her beloved Journal while per- 
mitting her greater freedom for original 
writing. She was a prolific spokesman for 
the profession of nursing and her work as a 
historian has won particular acclaim. 

The recipient of many honors, Miss 
Roberts numbered among them two of her 




Mary M. Roberts 

profession's highest tributes to outstanding 
leadership — the Florence Nightingale 
Medal and the Mary Adelaide Nutting 
Award. Writer, editor and historian, she 
has become a symbol of nursing through her 

professional stature. 

* * * 

Rachel (Monteith) Scarth who gradu- 
ated from Winnipeg General Hospital in 
1893 died in October, 1958. 

* * * 

Isabel (MacNicol) Sills, a graduate of 
Grace Hospital, Detroit died in October, 
1958. She was the first collegiate nurse 



240 



THE CANADIAN NURSE 



in the province of Ontario and served on the 
Windsor Board of Education for 28 years. 

* * * 

Mrs. Jane Stewart, a graduate of a 
hospital in Toronto, died in November, 1958. 
She had nursed in the sanitarium at Ninette, 

Man. at one time. 

* * * 

Gladys F. (Cramond) Vanderburgh 

who graduated from Hamilton General 
Hospital died in August, 1958. 

* * * 

Alice (Hilton) Wadge, a graduate of 



Winnipeg General Hospital in 1903 died in 
November, 1958 after a lengthy illness. 

* * * 

Anita Welburn who graduated from 
Royal Victoria Hospital, Montreal in 1955 
died from injuries received in a car accident 
on December 20, 1958. 

* * * 

Jean E. (Whitton) Wilson, a graduate 
of Victoria Hospital, London, Ont. in 1903, 
died on January 5, 1959. She had worked as 
a public health and school nurse for 25 years 
before her retirement. 



Color in Yonr Home 



Experts agree, dramatizing your house is 
easy — if you concentrate on color. The 
secret for successful completion of the for- 
mula is to aim for a coordinated color scheme 
— a plan where all the colors in a room 
harmonize or blend together. There are a 
few simple things to remember and then you, 
too, may be an expert. Avoid extremes. 
Avoid drab, matching colors like browns and 
grays which tend to be gloomy and boring. 
Avoid too many colors or distracting or 
meaningless contrasts. 

Start with one basic color. To help you 
make the best choice — and there are no set 
rules for this — think first of the colors 
that you like and that would provide the 
most effective and attractive setting for 
your own coloring. Then, analyze the room : 
the use, the size, and the kind of light it 
will receive. Living rooms should emphasize 
bright, cheerful colors if a cozy, cheerful 
feeling for long stretches of time is desired. 
To carry out the restful theme for bedrooms, 
cool colors are best in quiet, harmonizing 
blends. 

Red, yellow and orange tones are the warm 
colors best used in rooms facing north where 
there is little direct sunlight. Blue, violet 
and green tones are cool colors used to better 
advantage in sunny rooms. 

Once you select your basic color, interest 
and beauty may be heightened by the way in 
which tones and shades of this basic color 
are duplicated throughout the room. The en- 
tire color picture can be enriched by the ad- 
dition of complementary color shades. One 
easy method is to find the color desired in 
the pattern of an upholstery fabric or wall- 



paper. All the other shades are there, too 
— and you have the assurance of color com- 
binations and patterns designed by pro- 
fessional artists. Just repeat the basic color 
of the pattern for the wall coloring ; the 
deeper shades for the rugs ; and the brighter 
colors for the accent notes of the sofa pillows 
or other accessories. 

Although your redecoration has been start- 
ed with color added to your walls the room 
still needs a finishing touch. None is more 
elegantly, tastefully supplied, than with wall-, 
window-draperies or curtains. They complete 
the room's dressed-up appearance much the 
same as gloves, purse and jewelery complete 
a fashionable outfit. 

Inasmuch as draperies and curtains arc 
usually grouped around window areas, they 
create a focal point. Usually they represent 
the largest vertical areas in a room and 
therefore have a major eflFect on the room's 
appearance. To make a room seem higher, 
use straight curtains which hang from the 
top of the window to the floor. Horizontal 
patterns will have the opposite effect. 
— J. P. Stevens & Co., Inc. 




SYMBOL OF HOPE 
AND MERCY 

for 50 years . . . 1909-1959 



■,^^ 



^i A'«. V. 



MARCH, 1959 • VOL. 55. No. 3 



241 




PREPARED IN YOUR NATIONAL OFFICE, CANADIAN NURSES' ASSOCIATION, OTTAWA 



Ad Hoc Committee on Research 
Meets in Ottawa 

Of all the recommendations present- 
ed to the Executive Committee of the 
Canadian Nurses' Association, more 
have to do with research than with any- 
thing else. Some which have come be- 
fore the Executive in recent years 
would require a separate department 
within the CNA framework and would 
require more funds than the sum total 
of CNA revenues. 

In times like these, when health 
programs are developing and expand- 
ing so rapidly, the need for research 
in nursing is ever-present and imper- 
ative. Where the CNA fits in, and how, 
is the important question. To answer 
these and other questions, the Ad Hoc 
Committee on Research met for three 
days in December, 1958, under the 
chairmanship of Miss Lola Wilson, 
director. Study of the Aged and Long- 
term Illness, of the province of Saskat- 
chewan. 

The first thing the committee did 
was to accept a definition of "Re- 
search" — "Basic" and "Applied." 
The recommendations regarding re- 
search which had been referred to the 
Executive Committee during past years, 
were then studied and classified under 
such headings as "Nursing Needs of 
Society," "The Function of Nursing," 
"Philosophy, Aims and Objectives of 
Nursing Education," "Cost Studies," 
"Staff Utilization," etc. 

The committee then went on to out- 
line what it believes to be the areas 
of research in which the CNA should be 
involved and the sequence in which 
these activities should be undertaken. 
The committee also outlined recom- 
mendations which it believed were out- 



side the CNA scope. Some of the sug- 
gestions classified under this heading, 
it was felt, might better fall within the 
range of provincial nurses' associations, 
universities, or at local level. 

The committee established a priority 
for research projects and placed first 
on the list the establishment of a Nurs- 
ing Research Index in National Office. 

A full report of the committee's ac- 
tivities and recommendations will be 
brought to the Executive Committee 
of the Canadian Nurses' Association by 
the chairman at its meeting in Febru- 
ary, 1959 in Quebec. 

Projects for Committee on Nursing 
Service 

At the December meeting of the 
Committee on Nursing Service, the 
following topics were considered of 
prime importance for this biennium. 

1. Completion of a head nurse guide. 

2. Study of the impact of hospital 
insurance on nursing. 

A previous sub-committee had pre- 
pared material for a Guide for Head 
Nurses. It is planned to continue this 
work and to complete the Guide during 
this biennium. Based on the findings 
of "A Study of Functions and Activi- 
ties of the Head Nurse in a General 
Hospital," conducted by the Research 
Division of the Department of National 
Health & Welfare, the guide will define 
the term "head nurse," outline her 
qualifications and preparation and de- 
fine her functions and activities. It 
will also state general principles of 
administration, supervision and teach- 
ing and will clarify terminology. 

Involved in the discussion of the 
impact of hospital insurance on nurs- 
ing were the following topics : 



242 



THE CANADIAN NURSE 



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1. The expected increase in patient 
census, longer stay and the increas- 
ed demand for intensive nursing care 
resuhing from newer medical and 
surgical treatments. 

2. The responsibilities the nurses should 
have in the planning of new hospital 
construction. 

3. The changing patterns of nursing 
needs in tuberculosis, mental hygiene, 
geriatrics, home care plans and the 
newer surgical procedures. 

4. The changing role of the professional 
nurse and the need for adequate 
professional preparation for these new 
responsibilities. 

Recommendations proposed by the 
Committee on Nursing Service for pre- 
sentation to the Executive Committee 
will be discussed at the February meet- 
ing. 

Calling all CNA Alumnae 

Five years ago National Office cir- 
culated a questionnaire to 87 members 
of the "CNA Alumnae," graduates of 
the Metropolitan Demonstration School 
of Nursing, Windsor, Ontario. Through 
it M^e learned that 53 graduates w^ere 
actively engaged in nursing. Of these, 
18 had taken postgraduate university 
courses, 12 had entered the public health 
field, four had chosen nursing edu- 
cation and tw^o hospital administration. 
Marriage of course, had claimed a 
goodly proportion but many of these 
w^ere combining the two careers. 

In January, because of continued 
interest in the activities of "CNA 
Alumnae" members, a second question- 
naire was circulated. Through the kind 
assistance of one of the graduates. 
National Office has a list of current 
addresses. Among the missing are 16 
graduates. Are you one of the 16 who 
did not receive a questionnaire? Per- 
haps you know of someone who should 
have received a questionnaire. If so, 
please send National Office a current 
address. Our sincere gratitude will be 
forthcoming. 

The Canadian Nurses' Association 
is most anxious to keep in touch with 
members of its Alumnae. 

Pilot Project Study Folio 

The Study Folio on Accreditation 
has been revised in order to give you 



current information regarding the pro- 
gress of the Pilot Project. Newer 
articles on accreditation are included 
in the folio. The bibliography has been 
revised to include recent articles on the 
subject of accreditation. French and 
English copies of this folio may be 
obtained on request from National Of- 
fice. 

CNA Building Fund 

Appreciation 

We wish to express sincere apprecia- 
tion for the donations which have been 
made to the CNA building fund — 
To Miss Florence H. M. Emory for 
the generous donation which started the 
fund. 

To Dr. W. Stuart Stanbury for asking 
that the honorarium provided for the 
speaker giving the Mary Agnes Snively 
Memorial Lecture be added to the fund. 
To Miss Ella Howard for visiting 
National Office during the meeting of 
the Committee on Nursing Service and 
adding to the fund. 

Ideas for fund raising 

The ever-active National Office 
Auxiliary has now arranged to serve 
refreshments following chapter meet- 
ings with proceeds going to the build- 
ing fund. The February meeting of the 
Ottawa Area Chapter, R.N.A.O. Dis- 
trict #8, was the first meeting at 
which this project was launched. We 
shall keep you posted on future ac- 
tivities. 

Canadian Nurses' Association 
Retirement Plan 

Have you enrolled in the CNA Retire- 
ment Plan ? 

The aim of the C.N.A.R.P. is to 
enable you to save for the future in a 
manner that will achieve the following 
objectives : 

1. The money that you put into the plan 
will be deductible from your income 
for tax purposes. 

2. By participating in a group arrange- 
ment with other nurses throughout 
Canada, you will obtain a better 
pension than you could on your own. 

3. This plan has been especially designed 



244 



THE CANADIAN NURSE 





RADIUM 
BEDfATIENT 

BREAKFAsT] 



HOLD 



^ 



i 



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X-RAY TREATMENT , 



DIABETIC 



REST 




A simple, efficient reminder 
system that meets every need 

Makeshift reminders written on scraps 
of paper clon't provide the degree of 
safety and efficiency today's hospital 
practice requires. Scribbled notes are 
hard to read, they may be brushed off 
and they are unsightly. The Hollister 
reminder system overcomes these prob- 
lems in a way that enhances the appear- 
ance of the room and provides the 
greatest possible convenience. 

Hollister reminder cards are 
colorful and easy to read . . . 

Hollister Bed Signs show reminders 
and instructions at a glance. Boldly 
printed, colored reminder cards — easily 
-^a read from across a large room — slide 
JH smoothly into clear Plexiglas.* They 
stay in place, shielded from accidentally 
being brushed off or blown away. 

'Plexiglas is a trademaric of Rohm & Haas Co., Philadelphia 






'^end for your copy of the colorful new 16-page 
hook, Beautiful Bed Signs, that pictures and 
describes this modern reminder system, write — 



t 



Franklin C Hollister Company 
833 N. Orleans St., Chicago 10, III. 



MARCH, 1959 • VOL. 55. No. 3 



245 



to provide an answer to the rising 
cost of living. 
Booklets and application cards are 
available at 



Canadian Nurses' Association 

270 Laurier Avenue West, 

Ottawa, Ontario. 

Write Today 



^e ^Ttun^tt^ a tn>ciuen^ te fratf^ 



Le Cotnite de Pension se reunit a Ottawa 



De toutes les recommandations presentees 
au Comite Executif de 1' Association des In- 
firmieres canadiennes, la plupart se rapportent 
a la recherche. Parmi celles qui furent pre- 
sentees au cours des dcrnieres annees, il 
y en a qui necessiteraient I'etablissement 
d'un departement special, au sein de I'A.I.C. 
et qui demanderaient des sommes depassant 
le revenu total de I'Association. 

A une epoque on de nouveaux programmes 
de sante se creent et se developpent si rapi- 
dement, la recherche en nursing est d'actua- 
lite et s'impose. Quel est le role de I'A.I.C. 
dans ce domaine et par quels moyens peut- 
elle remplir ce role? Voila la question im- 
portante. Afin de repondre a ces questions 
et a d'autres du meme ordre, un comite 
special de recherche a tenu une reunion de 
trois jours a Ottawa, en decembre 1958, 
sous la presidence de Mile Lola Wilson qui a 
fait, en Saskatchewan, une etude sur "Les 
personnes agees et les malades chroniques." 

Le comite commenqa son travail par I'a- 
doption d'une definition des termes : "recher- 
che," " de base," et "applique." Les recom- 
mandations portant sur la recherche, presen- 
tees au cours de ces dernieres annees au 
Comite Executif, furent alors examinees et 
classees sous les rubriques suivantes : "Les 
besoins de la collectivite en matiere de 
nursing," "La fonction du nursing," "Philo- 
sophie, buts et objectifs de I'education en 
nursing," "Etudes du cout du nursing," "Uti- 
lisation du personnel," etc. 

Le comite determina alors les domaines 
dans lesquels, selon son point de vue, la 
recherche doit se pratiquer et I'ordre dans 
lequel I'A.I.C. doit proceder. Le comite 
fit aussi des recommandations concernant 
certaines questions qui ne relevent pas de 
la competence de I'Association, et dont cer- 
taines seraient plutot du domaine des associa- 
tions provinciales d'infirmieres, des univer- 
sites ou d'organisations locales. 

Le comite a ctabli une priorite dans I'ordre 



des projets de recherche, et en tete de la liste 
a place I'etablissement, au Secretariat na- 
tional, d'un "Catalogue de reclierches en 
nursing." 

Un rapport complet du comite et des re- 
commandations sera presente au Comite Exe- 
cutif de I'A.I.C. par la convocatrice, lors de 
la prochaine reunion de I'Executif qui aura 
lieu a Quebec en fevrier 1959. 

Projets du Comite du Service d'infirmieres 

Lors de la reunion du Comite du Service 
d'infirmieres tenue en decembre, les points 
suivants furent juges de premiere importance 
et feront I'objet des activites de ce comite 
au cours de la presente periode biennale. 

1. Le parachevement d'un guide a I'usage 
de I'infirmiere-chef. 

2. Etude de la repercussion de I'assurance- 
hospitalisation sur le nursing. 

Anterieurement, un sous-comite avait pre- 
pare la matiere pour la redaction d'un guide 
pour I'infirmiere-chef. Le comite se propose 
de continuer et de terminer le travail com- 
mence et de publier les resultats de cet ou- 
vrage d'ici deux ans. Base sur 1' "Etude des 
Fonctions et des Taches de I'lnfirmiere-chef 
dans un Hopital General," le guide definira 
le terme "infirmiere-chef," les qualites et la 
preparation requises pour cette fonction. On 
y trouvera egalement les principes generaux 
de I'administration, de la surveillance et de 
I'enseignement. La terminologie employee 
dans ce manuel deviendra plus uniforme et, 
par suite, plus claire. 

Au sujet de la repercussion de I'assurance- 
hospitalisation sur le nursing, les points sui- 
vants furent discutes : 

1. L'augmentation eventuelle du nombre de 
malades, de la duree de Thospitalisation, 
du volume de soins resultant de nou- 
veaux traitements medicaux et chi- 
rurgicaux. 

2. La responsabilite que les infirmieres 



246 



THE CANADIAN NURSE 



Make Nursing 

stn adventure 

with practical advantages 

As a Nursing Sister with the Royal Canadian Army Medical 
Corps, you get the excitement of adventure and travel . . . 
serving witli Canada's Army at home and overseas. 

Opportunities exist to work in the various fields of nursing 
such as teaching and supervision, nursing administration, pub- 
lic health, and operating room techniques and management. 

You receive officer's pay, allowances for uniforms, food and 
accommodation, phis 30 days annual holidays with pay. 

You may apply for a Regular Army appointment for a life- 
time career, or a Short Service Commission whereby you 
engage for a period of three, four or five years. 

// you are a Registered Nurse, 

under 35 years of age, 

and a Canadian citizen or 

British subject, 

write now for full 

information, 

without obligation to: 

Director General of 

Medical Services, 

Army Headquarters, 

OTTAWA, Ont. 





MARCH, 1959 • VOL. 55, No. 3 



247 



devraient assumer dans la preparation 
des plans de constructions d'hopitaux. 

3. La modification des besoins du public 
concernant les soins en tuberculose, en 
hygiene mentale, en gerontologie, soins 
a domicile et traitements chirurgicaux. 

4. Les changements dans le role de I'in- 
firmiere et la necessite de donner a I'etu- 
diante la preparation necessaire pour 
lui permettre d'assumer ces responsa- 
bilites nouvelles. 

Les recommandations faites par le Comite 
du Service d'Infirmieres au Comite Executif 
seront etudiees lors de la reunion de fevrier. 

Appel a tous les membres de I'Atnicale de 
I' A. I.e. 

II y a cinq ans, le Secretariat national 
adressait un questionnaire a chacun des 87 
membres de I'Amicale de I'A.LC, diplomees 
du cours de demonstration donne a I'Ecole 
Metropolitaine d'Infirmieres, Windsor, Onta- 
rio. Nous avons appris alors que 53 de ces 
diplomees exergaient leur profession, dont 18 
avaient fait des etudes post-scolaires a I'Uni- 
versite, 12 etaient engagees dans I'hygiene 
publique, quatre dans I'enseignement et deux 
dans I'administration. Le mariage avait re- 
clame sa large part mais plusieurs faisaient 
marcher de front les deux carricres. 

Vu I'interet particulier que porte I'A.I.C. 
aux activites de ce groupe, un second ques- 
tionnaire fut adresse a ces membres, grace 
a I'obligeance d'une diplomee demeuree en 
relation avec ses compagnes. Seize diplomees 
n'ont pu etre atteintes. Seriez-vous I'une des 
seize qui n'ont pas regu le questionnaire? 
Connaissez-vous une infirmiere qui aurait 
du recevoir un questionnaire et qui n'en a 
pas eu? S'il en est ainsi, veuillez done faire 
parvenir I'adresse actuelle de cette personne 
ou la votre, s'il y a lieu, au Secretariat na- 
tional et soyez assuree de notre gratitude 
pour ce service. L'A.I.C. tient beaucoup a 
demeurer en relation avec les membres de 
son amicale. 

Portejeuille — Projet d' accreditation 

Le portefeuille ou garde-notes contenant 
les renseignements sur le projet d'accredita- 
tion des ecoles d'infirmiere a ete revise de 
fagon a vous tenir au courant des progres 
de cette entreprise. Des articles nouveaux 
sur I'accreditation y ont ete ajoutes ; la 
bibliographic a ete revisee, et les plus re- 
cents articles sur I'accreditation y ont ete 
ajoutes. Pour obtenir ce portefeuille en 
frangais ou en anglais, veuillez vous ad- 



dresser au Secretariat national. 

Ponds de construction de l'A.I.C. 

Nous voulons exprimer notre reconnais- 
sance pour les dons regus en faveur du fonds 
de construction de l'A.I.C. 

A Mile Florence H. M. Emory, pour 
son genereux don : le premier regu. 

Au Dr. W. Stuart Stanbury qui a de- 
mande que le cachet offert au conferen- 
cier donnant le discours en memoire de 
Mary Agnes Snively au Congres Bien- 
nal, soit verse a ce fonds. 

A Mile Ella Howard, qui a visite le 
Secretariat national a I'occasion de la 
reunion du Comite du Service d'Infir- 
mieres, et qui a fait un don. 

Quelques idees pour alitnenter ce fonds 

Les dames auxiliaires du Secretariat na- 
tional ont decide d'oflfrir des rafraichisse- 
ments lors des reunions des divers chapitres 
et d'en verser les profits au fonds de cons- 
truction. Ceci fut inaugure lors de la reunion 
du chapitre de la region d'Ottawa, District 
No 8. de I'Association des Infirmieres de 
I'Ontario. Nous vous tiendrons au courant 
des initiatives prises a ce sujet. 

Plan de Retraite de 
l'Association des Infirmieres 

Canadiennes 

Vous etes-vous inscrite au Plan de re- 
traite de l'A.I.C? 

Le but de ce plan est de vous permettre 
d'epargner en prevision de votre retraite de 
fagon a atteindre les objectifs suivants : 

1. L'argent que vous verserez au plan sera 
deduit de votre revenu imposable. 

2. En participant a un plan collectif avec 
les autres infirmieres dans tout le Cana- 
da, vous obtiendrez une meilleure pen- 
sion que vous ne le pourriez indivi- 
duellement. 

3. Ce plan a ete specialement concu en vue 
de compenser la hausse du cout de la 
vie. 

Livrets d'instructions et cartes d'inscrip- 

tions peuvent etre obtenus de : 

L'Association des Infirmieres Canadiennes, 

270 ouest, avenue Laurier, 

Ottawa, Ontario. 

Ecrivez des aujourd'hui. 



The Canadian Red Cross Society has been 
serving Canada and the world since 1909. 



248 



THE CANADIAN NURSE 



new 

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bananas were indigestible. Today they are prescribed as one 
of the first solid foods fed to infants. 

For the past few years many patients have had the idea, 
equally erroneous, that bananas are "fattening." The fact, 
of course, is that bananas — like fruits as a class — 
are relatively low in calories. There are only 88 calories 
in a medium banana, according to the Canadian Department 

of Agriculture. (Table of Food Values.) 

And so another bugaboo is laid to rest. 

There is no reason to omit bananas from reducing diets. 

There are a wealth of reasons to include them: 

■ A wide range of vitamins and minerals in good 
balance with calories. 

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and as less soluble carbohydrates for sustained vitality. 
u High satiety value for appetite control. 
u Pectins and carbohydrates to aid digestion. 

■ Extremely low fat content— less than 0.2 per cent. 

m Sweet mellow flavor that rates high in patient acceptance. 
In addition, clinical experience has demonstrated the banana's 
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reducing diet— and every normal or maintenance diet, too. 

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Knrsing in Psychiatric Divisions of General Hospitals 

Report of a conference held on October 30 and 31, 1958 in the Allan 
Memorial Institute of Psychiatry, under the auspices of the Royal 
Victoria Hospital and McGill University. 



The conference, the first such large gather- 
ing of its kind, was planned as a forum 
for the exchange of experience and thinking 
in the comparatively new area of psychiatric 
nursing in a general hospital. Hospitals and 
psychiatric clinics, serving both English and 
French-speaking patients from Ontario 
through to the Maritimes and from the 
North-Eastern Atlantic seaboard of the 
United States, sent representatives from their 
general and psychiatric nursing stafifs. There 
were over 150 registered delegates from as 
far afield as British Columbia and the mid- 
western United States. A capacity audience 
of some 350 attended the final evening meet- 
ing which was open to all nurses. Miss 
Cynthia Lidstone, supervisor of nurses, The 
Allan Memorial Institute, chaired the Plan- 
ning Committee for the conference. 

From the beginning the conference was 
welcomed with enthusiasm by both general 
and psychiatric nurses. And further, the 
sessions proved to be so stimulating that 
requests were made by delegates that a 
similar conference be held annually. 

Session Highlights 

Speaking on the relationship between 
general and psychiatric nursing in a general 
hospital, Mrs. Isobel MacLeod, director of 
nurses, The Montreal General Hospital, 
stated that in her experience the presence 
of a department of psychiatry has greatly 
enriched the nursing care of patients in all 
sections of the hospital. She noted that with- 
in two or three years after the inauguration 
of the training program for student nurses 
conducted by the Department of Psychiatry, 
the impact began to be felt throughout the 
whole hospital, more so as these students 
joined the general staff upon graduation. A 
short time later a number of them were 
head nurses; then followed joint conferences 
arranged by the leaders in general nursing 
as well as by those in psychiatry which led 
to still further exchange. As a result the 
speaker felt all hospital patients today receive 
more 'comprehensive' nursing care. 

Another 'educational' experience which 
more and more frequently involves groups of 



general staff nurses is the referral to psy- 
chiatry of patients first admitted to hospital 
with physical illnesses. When these patients 
are transferred to psychiatry, the nurses 
who care for them are genuinely concerned 
and want to know how their former patients 
are getting along. Nursing leaders promote 
this natural interest by planning exchanges 
of information between former and present 
nurses. 

And finally, an exceedingly important 
conclusion was being reached by both general 
and psychiatric nurses : there are more simi- 
larities than differences in the nursing of 
patients in general medicine and those in 
psychiatry. The psychiatric nurse is begin- 
ning to look on her work as not so specializ- 
ed after all ; the general nurse is beginning 
to realize that every 'physical' illness has 
its psychiatric aspects too. 

Miss Harriet M. Kandler of the Lafayette 
Clinic, Detroit, told the conference that the 
role of a head nurse in the general hospital 
ward and a head nurse in the psychiatric di- 
vision of a general hospital is essentially 
the same. Miss Kandler, who recently con- 
ducted a notable four-year research project 
on the nurses' role in the socializing of 
mental patients, felt that a head nurse in 
the psychiatric ward has the added oppor- 
tunity of carrying greater responsibilities in 
administration, in leadership and in edu- 
cational programs for ward personnel. 

The guest speaker of the evening dinner 
meeting. Dr. D. Ewen Cameron, director of 
The Allan Memorial Institute, called for a 
system of training of nurses which does not 
stamp out the individuality and creative 
ability of the individual nurse. He realized 
that those training nurses were responsible 
for turning a teen-aged girl into a woman 
on whom major responsibilities must rest. 

"But," he stated, "I have never been con- 
tent that it should be done at such a cost 
in freedom of thought, such a loss of creative 
thinking, of speculation and conjecture." 

He continued : "I do not think it is be- 
yond the capacities of able nurse educators 
and nurse administrators to work out a sys- 
tem of training nurses whereby the graduates 
will have sufficient flexibility to work as an 



250 



THE CANADIAN NURSE 




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TODDifRS 



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is 


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COMPOSITE ANALYSIS 








Percent 


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Fat-Efher Extract 




1.65 


Available Carbohydrate— 






By Difference 




48.74 


Crude Fiber 




1.48 


Asfi- Minerals 




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Ash Includes 






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Phosphorus 




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Iron 




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Moisture 




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Calories Per Ounce 


99 


One ounce approximately 12 tablespoons. 



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Niacin 14.0 

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MARCH, 1959 • VOL. 55, No. 3 



251 



integral unit of the medical-nursing team 
under the direction of the doctor in the face 
of an emergency or in areas where unitary 
control is essential, yet at the same time 
be able to operate quite differently in terms 
of the freedom of thought, of speculation, 
inquiry and actual research activity when 
emergency demands are not present." 

Speaking on "The Education of the Under- 
graduate and Postgraduate Nurse in the Psy- 
chiatric Division of the General Hospital," 
Miss Elizabeth Bregg, assistant professor of 
psychiatric nursing, Frances Payne Bolton 
School of Nursing, Cleveland, Ohio, describ- 
ed the education of nursing students as 
directly related to the kind of psychiatric 
care the particular hospital offered. 

"If the psychiatric division is seen as 
a small mental hospital where, for the most 
part, decent custodial care is the aim, then 
the education offered students will be geared 
to this concept. Some psychiatric divisions 
are over-night stopping places or small al- 
coholic sanitaria. If such is the case, then 
the teaching of students will have to fit 
into this frame of reference. Whether such 
divisions are giving good or bad care is not 
the qvestion to be decided here. The point 
is that there has to be clarification of 
philosophy and standards before any student 
can be expected to learn and function in the 
setting." 

Miss P. C. Pike, head of the Teaching 
Department, The Allan Memorial Institute, 
noted that some of the fears the general 
nurse brings with her are the 'folklore of 
psychiatry' and are, in fact, attitudes preva- 
lent in the community but not based on fact. 
These false notions include the popular idea 
that all psychiatric staff members are a 
little 'mad' and that mental illness is con- 
tagious. 

"Many people, too, expect to find the 
psychiatric patient is mentally defective, 
although many of them personally know 
highly intelligent people who have had to be 
admitted to psychiatric hospitals. But offset- 
ting these handicaps, the nurse brings many 
positive nursing qualities. She brings warmth 
and mothers a ward full of patients as she 
would the children she hopes to have." 

Finally, the nurse has a fundamental de- 
sire to help others, a healthy curiosity about 
people and a sympathy for their problems. 
Her intelligence and above all her intuition, 
make her a valuable member of the treat- 
ment team. 

Dr. T. J. Boag of the attending staff of 
The Allan Memorial Institute in speaking on 
"The Role of the Psychiatric Nurse Work- 



ing in the Day Hospital" described the psy- 
chiatric nurse as a key figure in the Allan's 
Day Hospital. "She occupies a central po- 
sition in its social structure, and exerts 
greater influence on it than does any other 
single person." 

"But," Dr. Boag, continued, "this central 
position carries important implications for 
the functioning of the nurse. One necessity 
which should be self-evident, but which is 
often ignored, is that the composition of the 
ward staff must be reasonably stable. Fre- 
quent rotations create endless difficulties. 
The nurse must have guidance in the 
management of her relations with individual 
patients and this is best given by discussion 
sessions with the clinical team." 

The speaker said that in order to plan 
programs and handle group activities for pa- 
tients, the nurse needs help from a psychia- 
trist in a position to view the situation 
as a whole. She also needs his support and 
advice in the management of problems as 
they arise. If she does not get the necessary 
help, she is very likely to retreat into the 
security of the office and administration. 

"Even with appropriate help," Dr. Boag 
concluded, "the nurse in a psychiatric di- 
vision will find it difficult to move into pro- 
grams which are foreign to her previous 
training and experience. It is essential, there- 
fore, that attention be given to individual 
and group psychodynamics in the training 
of the psychiatric nurse. Continued in- 
service training in the form of seminars and 
discussion groups must run parallel to her 
work on the ward if she is to understand the 
problems she must handle every day and if 
she is to make the valuable contributions 
which only she, in her key position, can 
make." 

Dr. Esther Lucile Brown of the Russell 
Sage Foundation, New York, addressed the 
final evening session which was open to all 
nurses. A consultant to World Health 
Organization, she has advocated a greater use 
of the social sciences in the field of nursing 
and has initiated a number of research 
studies dealing with the psychological and 
sociological aspects of patient care. 

"One way to improve patient care is to 
bring into the hospital more of the positive 
values of family living and community life. 
In to-day's general hospital . . . too often 
patients are only regarded as so many 
horizontal figures under white sheets." Dr. 
Brown cited the exclusion from hospitals of 
children under 12 and animals when these 
may be of the greatest importance to the 
patient. 



252 



THE CANADIAN NURSE 



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MARCH. 19fi9 • VOL. 55. No. 3 



253 



Hospitals should promote the individual's 
ability to help each other. Dr. Brown cited 
as proof of this the case of polio patients 
being treated in hot water swimming pools 
rather than in Hubbard tanks. In the 
Hubbard tank treatment, one patient and the 
therapist work together. In the swimming 
pool, the therapist can instruct a number of 
patients at once and they advance more 
rapidly by working together and by helping 
each other. 

Another way to improve patient care is 
by giving psychological support to all the 
staflF, "particularly those most immediately 
and directly in contact with patients. This 
support is needed to improve the motivation 
and efficiency of the staff." 

While there is shortage of staff every- 
where, Dr. Brown feels much of this short- 
age is due to the fact that what staff there 
is, is not fully utilized. To make people work 
to their full capacity and enjoy it, "they 
must be given on-the-spot recognition and 



praise, and they must.be allowed to develop 
a group spirit without disruption through 
rotation." 

People who work in hospitals are in what 
Dr. Brown describes as "an anxiety-inducing 
situation." Because of this, they must be 
allowed an outlet for their frustrations and 
anxieties without fear of being penalized. 

Dr. Brown has great faith in the treat- 
ment of patients in small groups. By this 
she meant living and working together over 
a period of time. Through this method the 
patients are able to give a lot to each other 
and thus hasten their return to health. 

Mental hospitals are much more experi- 
mental in their approach to patient treat- 
ment than general hospitals. "The general 
hospital talks about a total person but seldom 
is much known about the patient other than 
his disease and how to cure it." 

Jean McCrimmon 
Mental Hygiene Institute 
Pine Ave. West, Montreal 



Jllberta Certified Nnrsins Aide Association 



Madeline Quirk 



THE FIRST ANNUAL provincial convention of 
this organization was held in September 
at the Royal Alexandra Hospital, Edmonton. 
Sixty-seven delegates, representing many dis- 
tricts of the province attended. Alberta led 
the way in organizing the first association 
of this kind in Canada. 

*A pre-registration coffee party was held 
in the School for Nursing Aides. The host- 
esses were the members of the Edmonton 
Chapter and the trainees from the school. 
This was followed by a tour of the school. 

The opening invocation was delivered by 
Rev. Wilson of the Norwood United Church. 
Messages of welcome were brought by Dr. 
Somerville, Deputy Minister of Health, Mrs. 
June Taylor, vice-president of the A.A.R.N., 
and Dr. Easton. administrator of the Royal 
.Alexandra Hospital. 

A highlight of the meeting was a panel 
discussion on "The Importance of Represen- 
tation through an Organized Group." The 
chairman was Mrs. Dorothy Cameron, 
Parent Education Chairman of the Feder- 
ation of Home and School Association, and 
the first vice-president of the Southern 
Group of the Alberta Region of the Canadian 



Mental Health .Association. Panel members 
were : Mrs. Van Dusen, executive director 
of the A.A.R.N. and Mr. Miller of the 
Canadian Mental Health Association. 

Dr. J. D. Griffin, National Director of 
the Canadian Mental Health Association was 
the guest speaker on the second day. He gave 
a most interesting talk on what mental 
health is and is not. This was followed by a 
buzz session and then a panel discussion. 

Mr. Jim Rennie, public relations official 
of the Imperial Oil Co. spoke on the subject 
of public relations. One of the objectives 
of the A. C.N. A. A. for this year is to set up 
a Public Relations Committee and to es- 
tablish a public relations program throughout 
the province. 

A poster contest had been held during 
the convention and Miss Jean Gold of 
Ponoka was the winner. A new style of 
apron made of better material was modelled, 
and a resolution passed that the present style 
should be changed. 

A feeling of good will and satisfaction 
that the first annual convention had been a 
success, was prevalent as the convention 
closed. 



254 



THE CANADIAN NURSE 



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MARCH. 1959 • VOL. 55. No. 3 



255 



^*a4 ^OAteca^ 



Research in Nursing by Amy Frances 
Brown, R.N., B.Ed., M.S. in N., Ph.D. 
352 pages. W. B. Saunders Company, 
Philadelphia, Pa. 1958. Price $5.75. 
Rct'.iezved by Miss Edith M. McDowell, 
Dean, School of Nursing, University of 
Western Ontario, London. 
Dr. Brown, in her preface, states a basic 
assumption from which we derive an impor- 
tant criterion, "One of the characteristics 
of a profession is that it has a body of know- 
ledge, the extension of which is directed by 
the members of that profession." That as- 
sumption should set in motion many kinds of 
activity, directed to the extension and re- 
finement of the knowledge from which we 
derive principles and concepts for the prac- 
tice of nursing. 

The author presents her book as "... a 
compact source of information on research 
methodology." 

Unit I discusses the meaning of research 
and briefly reviews the short history of the 
past decade which saw the beginnings of re- 
search activities in nursing — research by 
nurses for nursing. 

Units TI and /// outline the process, 
step by step, of methods and procedures in 
the light of sound and acceptable research 
practice. Nurses will find Dr. Brown's defin- 
itions and methods of particular usefulness. 

Unit IV turns the keen edge of research 
upon the clinical field as it is used in the 
education of students through practice in 
the care of patients. Two of the conclusions 
reached on the basis of completed studies 
should be especially provocative : 
. . . curriculum building has not been 
based upon any rationale of curriculum 
theory. ... of the several methods (cur- 
riculum planning) which have been used, 
none has provided a satisfactory method 
of meeting the learning needs of students 
or the nursing needs of patients. 
Chapter 13 cites briefly further studies 
that are needed in nursing. 

Teachers in schools of nursing might well 
begin with Chapter 12 — "Methods of Case 
Analysis for Inferring Learning Needs." 

We have long since recognized the inti- 
mate relationship that exists between quality 
nursing for the patient and the needs of the 
learner. The problems that arise because of 
our failure to admit this relationship have 
been our dailv meat for manv vears. The 



"truth" which have usually presented in 
our defence is frequently derived from con- 
venience, fear of dislocation of established 
routines and fear of change. 

Administrators, teachers and practitioners 
of nursing will and should welcome Dr. 
Brown's book. It is not only a rich and 
significant contribution to the literature of 
our profession ; it is a guide to the dis- 
covery of truth needed in facing contem- 
porary responsibilities in education and prac- 
tice. 

Modern Pharmacology and Therapeutics 

by Ruth D. Musser, A.B., M.S. and 

Joseph G. Bird, M.D., Ph.D. 794 pages. 

Brett-Macmillan Ltd., 132 Water St. S., 

Gait, Ont. 1958. Price $6.75. 

Reviezved by Margaret M. Egan, science 

instructor, General Hospital, Pembroke, 

Ont. 

This is a comprehensive, detailed, modern 
pharmacology text that is adaptable to the 
capabilities of the student nurse. It covers 
all phases of the subject. For the beginner 
it provides the fundamental principles upon 
which the student gan build knowledge 
acquired in the pursuit of her profession. 
Older concepts that have been supplanted by 
newer ideas and methods have been deleted. 
The student is not burdened with information 
that is no longer applicable. For the more 
advanced student drugs are presented under 
the various functional units with clinical and 
pathological illustrations showing the re- 
lationship of the disease to the drug and its 
action. This approach should enable the 
nurse to organize and retain knowledge with 
greater ease. 

Other noteworthy points are the thought- 
l)rovoking questions and references listed at 
the end of each chapter and the diagrams and 
tables used throughout the book. The sub- 
ject of drug addiction is well discussed anii 
provides much information. 

The content of the text provides for more 
than the needs of student nurses. For this 
reason it should be valuable for students 
in related fields, for instructors or as a 
library reference book. 

Evaluation in Basic Nursing Education 

by Mary Tschudin, Helen C. Belcher and 
Leo Nedelsky. 304 pages. G. P. Putnam's 
Sons, 121 Sixth Ave., New York 13, N.Y. 



256 



THE CANADIAN NURSE 



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MARCH, 1959 • VOL. 55, No. 3 



257 



Reviewed by Miss Alma E. Reid, Hamil- 
ton College, McM aster University, Ha- 
milton, Ont. 

Are you interested to know how one school 
of nursing is carrying out a comparative 
study of two basic programs, one experi- 
mental and the other estabHshed ; has sorted 
out and agreed upon a general theory of edu- 
cational measurement whereby the two cur- 
ricula may be evaluated; has arrived at 
objectives of content and behavior that stu- 
dents in basic nursing education should 
attain ; has evolved methods of evaluation 
in all fields of clinical nursing including 
public health nursing ; has devised means 
whereby principles from the natural and 
social sciences may be elicited and tested 
in nursing practice ; has described a variety 
of techniques that may be used in evaluat- 
ing nursing practice? If so, go to this book, 
for in it all these and many other interesting 
questions are discussed. 

This is the second volume of the report 
of the five-year curriculum research project 
in basic nursing education, begun in 1952 at 
the School of Nursing, University of 
Washington, Seattle. The project has to do 
with the improvement of instruction in basic 
nursing education so that a "competent" pro- 
fessional nurse may be prepared in a shorter 
period of time. Tn the first volume of the 



series reporting on the project. Curriculum 
Study in Basic Nursing Education by Ole 
Sand, the basis of the project was outlined 
and discussed. It seemed logical and essential 
that evaluation should take a central and 
important place in the study and that the 
next volume should be devoted to this topic. 
Here, in the words of the authors, this is 
stated, "We found that evaluation is an 
integral part of curriculum study; that eval- 
uation is essential to determine whether 
students have attained curricular objectives 
and to what degree." Hence the second 
volume, with evaluation quite rightly enjoy- 
ing the limelight of the project. 

Those of us who have struggled with thi.s 
difficult and important question of evaluation 
in nursing will read this account with in- 
tense interest and will assuredly welcome 
some new ideas on the subject. While it is 
acknowledged by the authors that all their 
problems of evaluation in basic nursing edu- 
cation are by no means solved or even tackl- 
ed in this treatise, nevertheless considerable 
light is shed on interesting and new possi- 
bilities — possibilities that are stimulating 
and well deserved exploration in our own 
situations. This worthwhile project in curric- 
ulum research gives us relevant findings 
which undoubtedly can be helpful to us in our 
own programs in nursing education. 



TEST POOL EXAMINATIONS 



FOR 



REGISTRATION OF NURSES 

IN 

NOVA SCOTIA 

To take place on May 20, 21 and 22, 
19.S9 at Halifax, Yarmouth, Amherst, 
Sydney and Antigonish. Requests 
for application forms should be made 
at once and forms must be returned 
to the Registrar not later than April 
13, 1959, together with 

1. Diploma of School of Nursing. 

2. Fee of Fifteen Dollars ($15.00) 

No undergraduate may write unless 
he or she has passed successfully all 
final school of nursing examinations 
and is within six (6) weeks of com- 
pletion of the course in nursing. 

NANCY H. WATSON, R.N., REGISTRAR, 

THE REGISTERED NURSES' ASSOCIATION 

OF NOVA SCOTIA, 

73 COLLEGE STREET, HALIFAX, N.S. 



Nurses are invited to be the guests ut tin- 
American College of Surgeons at a four-day 
meeting of the College in Montreal, P.Q., 
.\pril 6-9, 1959. Housing and meeting head 
(|uarters for the nurses will be at the Sheraton 
Mount Royal Hotel. This invitation includes 
attendance at extensive programs arranged 
for nurses, hospital visits, various demonstra- 
tions and attendance at all sessions prepared 
for surgeons and surgical specialists. 

The meeting is planned for the interest of 
all personnel concerned with treatment of 
surgical patients — from preoperative work- 
up through anesthesia, operating room, 
recovery room, postoperative care and re- 
habilitation. 



A good deal of ritual was always part of 
all primitive medicines. The following is 
an Irish cure for mumps. "Tie a halter round 
the neck of the child and lead him to a 
brook. Bathe him three times three in the 
name of the Blessed Trinity."' 

— Encyclopedia of Superstitions 



258 



THE CANADIAN NURSE 



IN THE MILDER MENTAL AND 
EMOTIONAL DISORDERS AND IN 
NAUSEA AND VOMITING, OPTIMUM 
RESPONSES USUALLY OBTAINED 
WITH 2 TO 4- MO. DAILY 

rapid onset of action 
effectiveness in extremely small doses 
prolonged therapeutic activity- 
freedom from drowsiness and depressing effect 
low incidence of side reactions 



as a tranquilizer and antiemetic 




STELAZINE 



as an antipsychotic agent 

• effective in withdrawn, apathetic schizophrenics 

• effective in chronic patients relegated to ''back wards" 

• marked beneficial effect on delusions and hallucinations 

• fast therapeutic responses at low doses 

• inherent long action allows b.i.d. administration 

IN HOSPITALIZED PSYCHIATRIC 
PATIENTS. ESPECIALLY THOSE 
UNRESPONSIVE TO PREVIOUS 
THERAPY, OPTIMUM RESPONSES 
USUALLY OBTAINED \A/!TH 
10 TO 20 MG. DAILY 

SMITH KLINE 8c FRENCH • MONTREAL 9 



•REQ CAIN T 



OFF FOR TRIFLUOPERAZINE. 3 K F 



MARCH. 1959 • VOL. 55. No. 3 



259 



Garbage in the Sky 



If all the dirt that accumulates in the 
air of an average city in one year settled 
to the ground at once, the city would be 
covered by a 21 -foot avalanche of soot and 
debris ! The possibility of such a disaster 
is remote but the murky cloud hanging over 
the heads of urban dwellers in particular is 
causing grave concern. 

Within recent years people have died be- 
cause polluted air settled like a heavy blan- 
ket over the area and did not raise for 
several days. For example, in London, Eng- 
land, the death toll was estimated in thou- 
sands during the acute episodes of air pollu- 
tion in 1948, 1952 and 1956. In the interval 
it was discovered that others who had been 
exposed to the efifects of severe air pollu- 
tion and were seriously ill as a result of it, 
have tended to become ill with greater fre- 
(|uency and have a shorter lifespan. 

Air pollution is directly related to the 
incidence of chronic bronchitis — a condition 
ranked as third in the causes of death in 
England, although we do not rate it so on 
the North American continent. There has 
been widespread condemnation of cigarette 
smoking as a cause of lung cancer but less 
well advertised is the fact that mortality 
rates for lung cancer are noticeably higher in 
urban as compared to rural areas regardless 
of smoking habits. 

Sulfur oxides in the air tend to make 
breathing more difficult. Ozone, which occurs 
in some air supplies, has been found to 
cause scarring of lung tissue in animals and 
may also cause pulmonary edema. Eye irrita- 
tion <is a common complaint. Evidence is be- 
ginning to accumulate that makes air pollu- 
tion suspect in such conditions as arterio- 
sclerotic and other heart conditions, cancer 
of the trachea, stomach and esophagus. 

If you need further proof that the air 
around you is not as pure as you think it 
is — consider the size of your yearly clean- 
ing bill ; count up the number of times your 
white curtains have gone to the laundry : 
glance in the mirror at your soot-speckled 
face after a trip downtown ; talk to the real 
estate agent who is trying to sell housing 
])rofitably in a highly industrialized area. 
One American city estimated that property 
values were declining $25 million a year be- 
fore it began a clean air campaign. 

Unfortunately more than one chemical 
agent is involved in air pollution. Otherwise, 
control measures would be simple since in- 



dustry could remove the offender from dis- 
charge waste products. The toxic substances 
are the end-products of chemical interaction 
among the combined total pollutants of a city. 
During an acute episode a heavy fog contain- 
ing the pollutants — chemicals, smoke or 
fumes — settles over the area and is held 
in place by a layer of heavy, cold air that 
acts like the lid on a jar. Generally speak- 
ing, the aged and infirm tend to die from the 
effects and serious illness results in other. 

What is being done to control air pollu- 
tion? In the United States, as an example, 
industry has been spending millions of dollars 
yearly on methods of control. Some cities 
prohibit the use of certain fuels for furnaces 
— fuels that do not burn efiiciently and 
therefore discharge unspent gases into the 
air. "After-burners" — devices to oxidize 
more completely or burn the fuel in the 
automobile exhaust — are being developed. 
There is a possibility that in some cities 
where air pollution is a particular problem, 
each car may be required to have an after- 
burner. Air conditioning units do help to 
a certain extent by filtering out dust and 
other particles. Research is going on con- 
stantly to determine just what the effects 
of air pollution are biologically. The knowl- 
edge gained so far has been encouraging. 

Eventually when the city dweller puts on 
his hat and coat to step out for "a breath 
of fresh air," he may be able to get it. 



The week of February 1-7 was set aside as 
National Health Week in Canada. Medical 
science has made great strides but — 

One out of every 50 Canadian adults is 
an alcoholic : the number of alcoholics has 
doubled in 10 years; there are only five 
countries with a worse rate of alcoholism 
than Canada. 

Over 95% of the population of Canada is 
afflicted with diseases originating in the 
mouth and diseases resulting therefrom. 
There is only one dentist for every 3000 
Canadians. Fluoridation of communal water 
supplies can positively prevent 60% of tooth 
decay. 

Over 500 million dollars is lost annually 
in wages through absenteeism, much of which 
is preventable. 



260 



THE CANADIAN NURSE 



ACNE 



T<Miex 



degreases the skin 
and helps remove blackheads 




/^■^ X ¥ 



I 



rt 






\ H 




Fostex confains a combinafion of surface 
active agents (Sebulytic*) which: 

< Completely emulsify excess oil so that 
it is quickly washed ofif the skin. 



4 Penetrate and soften comedones, 
unblocking the pores and facihtating 
removal of sebum plugs. 



FOSTEX CREAM 

for therapeutic washing of 

(kin in the initial phase of acne 

treatment, when maximum 

degreasing and peeling 

ore desired. 

FOSTEX CAKE 

for maintenance therapy to 

keep skin dry and substantially 

free of comedones. 



Fostex dries and peels the skin 

< The Sebulytic base of Fostex dries and 

promotes peeling of the skin . . . actions 

enhanced by the keratolytic effects of 

micropulverized sulfur and sahcyhc acid. 

*(Sodiuin lauryl sulfoacetate, sodium alkyl aryl 
polyether sulfonate, sodium dioctyl sulfosuccinate.) 



Fostex is easy for yow patients to use 

^ Patients stop using soap on affected skin 
areas. Instead they use Fostex for thera- 
peutic washing of the skin. The Fostex 
lather is massaged into the skin for 5 min- 
utes—then rinse and dry. 

WESTWOOD Pharmaceuticali 

Buffalo, New York 

Canadian Distributor: John A. Huston Company, Ltd. 

Toronto 1 0, Canada 




MARCH. 1959 • VOL. 55. No 3 



261 



Ontario 



The following is a list of changes in the 
Ontario Public Health Services. 

Appointments — Elisabeth M. Hanna, 
(Toronto Gen. Hosp., Univ. of West. Ont.) 
and Georgette Proulx, (Ottawa Gen. Hosp., 
Univ. of Ottawa) formerly of Prescott and 
Russell Health Unit to Carleton H. U. 
Norma L. Compton, (T.G.H., U.W.O.) to 
Chatham Board of Health. Marjorie Sykes, 
(Hamilton Gen. Hosp., Univ. of Toronto) 
to Haldimand Co. H. U. Vernanne G. 
(Ptirdy} Druntmond, (U. of T. S. of N., 
U. of T.) to Kitchener B. H. Carolyn 
(Greemvood) Daley, (The Presbyterian 
Hosp., New York, U. of T.) to Lennox 
and Addington H. U. Marion (McEachran) 
Gauvreau, (Victoria Hosp., London, U.W. 
O.) ; Debora (Merkus) Dykstra, (City 
Hosp., Leeuwarden, Prov. Friesland, Nether- 
land) and Barbara J. Irwin, (Toronto 
West. Hosp., U.W.O.) to Middlesex Co. 
Health Service. Ethel Vera Slocombe, (H. 
G.H., U. of T.), formerly of Dufferin Co. 
H. U. and Mary Ann (Empey) Kerr, (Royal 
Jubilee Hosp., Victoria, Univ. of Alta.) to 
Oshawa B.H. Leonida Pillion, (St. Croix 
Hosp., Drummondville, P.Q., Univ. of Mont- 
real) to Stormont, Dundas and Glengarry 
H. U. Blanche Gordon. (T.W.H., U. of T.) 
to York Co. H. U. 

Resignations — Helen (Wray) Currie, 
from Ayr and N. Dumfries Township, Wa- 
terloo Co. Winona Inches, Alice G. Keryluk, 
Adele M. Fetterley, Sheila McLeod, Audrey 
Seifred from Fort William and Dist. H.U. 
Lois Humphries, Lossy Malowany, Sylvia 
Young, from Kenora Dist. H.U. Mrs. Lillian 
McLean, from Lincoln-St. Catharines H.U. 
Elisabeth (Burn) Nicolson, from Leeds and 
Grenville H.U. Mary E. Highstead, from 
Middlesex Co. School Health Services. 
Margaret Winfield, from Muskoka and Dist. 
H.U. Bee H. McKerracher, from Oshawa 
B.H. Margaret Hill, from Timiskaming H. 
U. Mary Isabel (Sheller) Coome, Margaret 
J. (Kernaghan) Hefferon, and Audrey Ruth 
Wale (McDermott,) from Scarborough B.H. 
Retired — Margaret Nealon, from Guelph 
B.H. 



Since its inauguration in 1947, the Cana- 
dian Red Cross free blood transfusion service 
has supplied more than 2,500,000 bottles of 
blood for free transfusions to patients in 
Canadian hospitals. 



Dictionaries are like watches ; the worst 
is better than none, and the best cannot be 
expected to go quite true. 



Tteco^ 'Ttotc^ 



ALBERTA 

The members of Hinton chapter heard re- 
ports from Mrs. D. Hallam and E. Dragland, 
at their January meeting, of the conferences 
they had attended earlier. Members of the 
1959 executive were elected and a member- 
ship fee decided upon. Drumheller chapter 
reported the addition of several new members 
and decided on a regular meeting time of the 
first Wednesday in each month. Westlock 
members held their first meeting of the new 
year as a combined annual meeting and 
dinner party. New officers were elected — 
Mrs. P. Leriger, pres. ; Mrs. L. Schmuland, 
vice-pres. ; Mrs. R. Renaud, sec; J. Mont- 
gomery, treas. High River chapter gave a 
donation of $50 for furnishings for the new 
office building and elected its new executive : 
Jean Squire, pres. ; Beverly Cross, vice- 
president ; Mildred Cox, secretary ; Nellie 
Caswell, treasurer. 



District 3 



Calgary 



Holy Cross Hospital 

The alumnae association recently elected 
its new executive. The members in office 
are : Mrs. W. MacDonald, past pres. ; Mrs. 
F. E. Hammer, pres. ; Mrs. A. M. S. Brown, 
vice-pres. ; Mrs. P. Poole, rec. sec. ; E. E. 
Newton, corr. sec; Mrs. C. F. Jackson, 
treas. ; Mrs. E. Wright, courtesy ; Mmes 
K. Calvert, A. Benner, Miss R. O'Byrne, 
membership ; Mmes A. Fitzsimons, E. J. 
Valentine, V. O'Connor, paper; Mmes E. 
Sikna, L. Leach, Miss Hotsenpillar, refresh- 
ments ; J. McGowan, J. LaCaste, Mmes K. 
Moore, H. C. Johnson, program; Mmes G. 
Powell, A. Swidinski, A. Beavers, Miss J. 
Cummins, ways and means. 

District 4 

Mkdicixe Hat 

Twenty-three members attended the annual 
meeting of the chapter in January. Nomin- 
ations for the offices of president and vice- 
president of the AARN were received and 
are to be submitted to the provincial nomin- 
ating committee. The director of the com- 
munity nursing registry reported a total 
of 298 calls for the year 1958 of which 62 
were not filled. The chapter executive for 
this year is : Mrs. L. G. Desharnais, pres. ; 
R. Ziehran, Mrs. D. Stevenson, vice-pres. : 
F. Ireland, sec. ; W. Schmidt, treas. 

The guest speaker for the evening, Mr. 



262 



THE CANADIAN NURSE 



Is Habit Keeping You From Considering Many 
of These Weil-Known Mosby Textbooks ? 

Soon-to-be- Released ! 5th Edition Anthony 
TEXTBOOK OF ANATOMY AND PHYSIOLOGY 

Includes a New, Color Trans-vision Insert Dissecting the Torso 

Discover how the completely revised new edition of this popular text can make your 
teaching easier. The soon-to-be-published 5th edition has been completely redesigned 
and modernized for greater readability. A new, more readable type face has been 
used and the page size has been increased to 6^" x 95^". All illustrations have been 
clearly relabeled. Questions have been interspersed throughout the book to arouse 
students' curiosity and interest and inspire further study. This new edition now 
contains a new 8-page, color trans-vision insert which helps the student understand 
the anatomical dissection of the torso, through the use of acetate overlays. 

By CATHERINE PARKER ANTHONY, R.N., M.A., Assistant Professor of Nursing, Science Department, Frances Payne 
Bolton School of Nursing. Ready this month, 5th edition, approx. 525 pages, 6V]" x 9'/]", 294 illustrations, 17 
color plates. About $5.25. 

Soon-to-be- Released! 3rd Edition Francis 
INTRODUCTION TO HUMAN ANATOMY 

Emphasizes the Correlation of Structure and Function 

Present anatomy as a living subject! With concise but complete descriptions of 
tissues organs and systems, this book presents the essentials of human anatomy in a 
manner that is understandable and easy to grasp. Particularly well illustrated, this 
text correlates structure and function throughout. You'll find modern concepts incor- 
porated in the largely rewritten section on the autonomic nervous system and the 
chapter on the endocrine system. Review questions at the end of each chapter and 
summarizing tables are helpful. 

By CARL C. FRANCIS, A.B., M.D., Associate Professor of Anatomy, Department of Anatomy, Western Reserve 
University, Cleveland, Ohio. Ready March 15, 1959. 3rd edition, approx. 500 pages, S'A" x 8V2", 324 illustrations, 
29 color plates. Price, $5.75. 

Soon-to-be-Released! 3rd Edition Lennon 

SOCIOLOGY AND SOCIAL PROBLEMS IN NURSING 

Places Emphasis on the Patient as a Person 

This book is a concise, logical and well documented presentation of broad sampling 
of sociological problems found in nursing. Emphasis is on the patient as a person and 
adaption of nursing care from that standpoint. The new 3rd edition contains stimula- 
ting discussions of two controversial subjects not usually found in sociology books 
— eugenics and sterilization. Review questions, practical bibliographies and summary 
outlines provide excellent study aids for your students. 

By SISTER MARY ISIDORE LENNON, R.S.M., R.N., B.S., M.A., M.S.W., Director of Social Service Department, St. 
John's Hospital, St. Louis, Missouri. Ready May 1959. 3rd edition, approx. 500 pages, 5V]" x 8V]", 64 illustra- 
tions. About $5.00. 



Gladly Sent to Teachers for Consideration as Texts 

Write to: 

THE C. V. MOSBY COMPANY 

3207 Washington Boulevard, St. Louis 3, Missouri 

Represented in Canada by: 

McAINSH and Co., Ltd. • 1251 Yonge St. « Toronto, Ontario, Canada 

MARCH. 1959 • VOL. 55. No. 3 263 




The Posey "V" RESTRAINT 

A good all-purpose restraint to prevent 
patients from failing or getting out of 
bed. Particularly good for use on females 
as it does not irritate busts. Available in 
Small, Medium and Large sizes. 

Posey "V" Restraint Cat. No. V-958 
Price $6.90 ea. 

SEND YOUR ORDER TODAY 



J. T. POSEY COMPANY 



2727 E. FOOTHILL BLVD., 
PASADENA, CALIFORNIA 



L. King, outlined developments in civil de- 
fence for the area. 



District 7 



Edmonton 



Royal Alexandra Hospital 

Members of the alumnae association elected 
the following slate of officers at their an- 
nual meeting: Mrs. O. Hennig, pres. ; J. 
Taylor, D. Watt, vice-pres. ; Mrs. O. Tookey, 
rec. sec. ; Mrs. B. Ofstadal, corr. sec. ; M. 
Goodland, treas. ; L. Clark, social convener ; 
Mrs. H. McMillan, assistant social convener ; 
J. Hamilton, scholarship; W. Riley, benefit 
& loan; M. Cameron, sick visiting; Mrs. M. 
McLeay, Blue Book ; Mrs. O. Morrison, 
news letter ; Mrs. D. Fraser, press and rep. 
to The Canadian Nurse; Mrs. B. Marples, 
Local Council of Women ; Mrs. O. Moore, 
United Nations. 

University of Alberta Hospital 

The new officers of the alumnae associ- 
ation were installed at a recent meeting. 
Forming the executive are : Patricia Mac- 
Millan, president; Mrs. J. Edwards, vice- 
pres. ; Mrs. K. Hodgson, rec. sec. ; Mrs. P. 
Stewart, corr. sec. ; Mrs. H. Hole, treas. ; 
Mmes F. D. Mace, W. J. McLihan, pro- 
gram committee ; Mmes G. W. Elkington, S. 
Antonink, social committee ; Mmes J. E. 
Greenaway, R. B. Cox, W. M. Taskey, 
membership committee. 



BRITISH COLUMBIA 



COMOX 



Members of the Plateau chapter met at 
St. Joseph's Hospital recently and elected 
their executive for this year. Mrs. W. K. 



Hind accepted the presidency with Mrs. M. 
Calnan, vice-pres. ; Sr. M. Alan, rec. sec. ; 
Miss Scavarda, corr. sec; Mrs. Dansereau, 
treas. Mrs. Hind presented her report of a 
provincial council meeting held in Vancouver, 
and Sr. St. Thomas described the inservice 
training institute held at Nanaimo. 

KaMLOOI'S 

Royal Inland Hospital 

As their own particular project in recog- 
nition of the province's Centennial, the 
alumnae association purchased a Multiplex 
swing panel on which pictures of the gradu- 
ating classes throughout tlie liospital's his- 
tory will be mounted. When completed the 
panel will be placed in the new nurses' 
residence. During Her Royal Highness. 
Princess Margaret's visit, Mrs. Rawson, a 
graduate of 1915 and a former member of 
Queen Alexandra's Imperial Nursing Serv- 
ice, was presented. At the final meeting of 
the year the new slate of ol'iicers was elected : 
Mrs. R. Jamieson, pres. ; Mmes A. Barclay, 
D. Fraser, vice-pres. ; Mrs. A. Duck, sec. ; 
G. Taylor, treas. 

MANITOBA 

District 2 

Brandon 

General Hospital 

Members of the alumnae association en- 
joyed an informal social evening featuring 
singing, contests and a monologue at one of 
their recent regular meetings. Mmes D. 
Speakman, D. J. Cowie and Miss M. Jackson 
were the contest winners. Mrs. R. Griffin, 
and Mrs. D. L. Johnson, were in charge of 
arrangements. 



264 



THE CANADIAN NURSE 



Winnipeg 
General Hospital 

The alumnae association has tentatively set 
the date for the annual tea party for early 
April. The graduation dinner and dance is 
to be held May 6 at Royal Alexander Hotel. 

Following one of their general meetings 
the members were shown through the new 
wing of the hospital. The starting point was 
the front entrance on William Avenue and 
from there through the White Cross Guild 
Gift and Flower shop, the business offices, 
the administrative and nursing service of- 
fices ; tlie laboratories, records, x-ray, phar- 
macy and out-patient departments and one 
of the semiprivate wards. In all areas, 
special attention was directed to the many 
time-saving and up-to-date facilities. 

Miss Irene Cooper as guest speaker at 
another meeting shared some of the high- 
lights of her work as relief instructor in 
obstetrics at the Nursing School in Alex- 
andria, Egypt. She was away five months 
and during that time, she experienced many 
unusual situations, each of which was most 
vividly described. 

December brought forth the spirit of 
Christmas and the desire to share Christmas 
stories and carols with friends. Rev. Philip 
Petersen of the Unitarian Church related at 
the Christmas alumnae meeting how the 
many practices and customs of Christmas 
came into being — the singing of carols, 
decorating the tree, the use of lights, burn- 
ing the Yule log. Complementing this nar- 
rative was the singing of Christmas selec- 
tions by the Student Nurses' Glee Club and 
the reading of the Christmas story from the 
Bible. 



NEW BRUNSWICK 

MONCTON 

A regular meeting of the local chapter 
of the NBARN was held in the nurses' 
residence of Moncton Hospital recently with 
27 members present. 

In compliance with a request from the 
provincial office a survey of service clubs 
in the city is to be carried out to determine 
their various health projects. Guest speaker 
for the evening, Miss Dell Mc.A.uley, a mem- 
ber of the city council, was introduced by 
Mrs. Roberta Perry. Miss McAuley's talk 
on "Civic Affairs" was most informative 
and interesting and was followed by an 
open discussion. 



NOVA SCOTIA 



Windsor 



The Christmas meeting of the Cape Breton 
and Victoria Branch of the RNANS was 
held at St. Elizabeth Hospital, North Syd- 
ney. Preclinical students from the hospital 
and local high school students presented a 
musical program of carols and Scottish 
songs. 



GOOD-LITE 

PORTABLE LOW COST 

VISUAL TESTING 

EQUIPMENT 

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ISUAL ACUITY 



The Good-Lite Model 
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2. HYPEROPIA 



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MUSCLE IMBALANCE 
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MARCH, 1959 • VOL. 55, No. 3 



265 




EXCLUSIVE CANADIAN 
SOURCE FOR 

NURSE'S SURGERY CAP 

ELASTIC OR DRAWSTRING 
SNOOD STYLE 



SEVEN WAYS SUPERIOR! 



ONTARIO 

District 1 



QUEEN'S UNIVERSITY 
SCHOOL OF NURSING 

COURSES OFFERED 

Undergraduate 

Degree Course, 5 years leading to 
BNSc. Degree 

Graduate Nurses 

a. Degree Course, two years. 

b. Diploma Courses, one year. 
Public Health Nursing 

or 
Teaching and Supervision in Schools 
of Nursing. 

For information apply to: 

DIRECTOR 

SCHOOL OF NURSING, 

QUEEN'S UNIVERSITY 

KINGSTON, ONTARIO 



Chatham 



Public (Jeiicral Hospital 

At the annual alumnae meeting, Mrs. 
Margaret Fraser was elected president ; 
Annie Head and Mrs. J. K. Keenan, vice- 
presidents ; Mrs. C. Bennett, recording sec- 
retary ; Mrs. D. Nichols, corresponding sec- 
retary and Winnifred Fair, treasurer. Mrs. 
G. Brisley is the representative to The 
Canadian Nurse. 

Windsor 

Hotel Dieii Hospital 

Among the new executive members of the 
alumnae association are : F. Fortune, pres. ; 
J. Cazabon, vice-pres. ; R. Goldhawk, treas. ; 
R. Labute, rec. sec. ; L. Burke, social sec. 
The new officers were officially installed 
at the January meeting. Mrs. D. Kurcz was 
a guest of honor at a party in the nurses' 
residence prior to leaving the staff. E. 
(Ballard) Nader is working at the Methodist 
Hospital, Arcadia, California. C. (Caza) 
Bogard is on the staff of a medical center 
in Knob Noster, Missouri. B. (Foster) 
Perry is on the staff of Detroit Memorial 
Hospital and S. Fyfe is office nurse for a 
doctor in the same citv. 



District 2 



Brantford 



General Hospital 

During the past months the alumnae as- 
sociation entertained the members of the 
graduating class and were hostesses to out- 
side graduates who attended a regular meet- 
ing at which Dr. B. Henry was the guest 
speaker. Mr. B. Beaumont of the Community 
Welfare Bureau spoke to the members on 
another occasion and described the activities 
of his organization. In the same month a 
very successful fashion show featuring winter 
clothing was held. The graduating class 
presented "Follies of '58" at the last regular 
meeting of the season as their contribution 
to a delightful social evening. 

District 3 

GUELPH 

St. Joseph's Hospital 

At the first regular meeting of the alum- 
nae association in the new year, the follow- 
ing members were elected to office : G. Miller, 
pres. : Mrs. A. Mezzabotta, vice-pres. ; Mrs. 
A. Watson, rec. sec. ; M. Ford, corr. sec. ; 
C. Beliski, treas. ; S. Turner, social con- 
vener ; M. Hanlon, sick call convener. 



266 



THE CANADIAN NURSE 



District 4 



Hamilton 



St. Joseph's Hospital 

The alumnae association has elected its 
new slate of officers. Included in the ex- 
ecutive are : Mrs. L. MacKenzie, pres. ; 
Mrs. E. Newman, vice-pres. ; Mrs. E. Mar- 
caccio, corr. sec. ; Mrs. S. Rumbles, rec. 
sec. ; W. Walker, treas. ; T. Malone, rep. 
to press and The Canadian Nurse; Mmes 
D. Markle, H. McManamy and Miss M. 
Hays, advisory board. During the past 
holiday season, gift hampers were distributed 
to four needy families. Dr. Krar, one of the 
city's obstetricians, spoke at a recent meet- 
ing and reviewed the developments in his 
field and the subsequent efifects on the prac- 
tice of obstetrics. Mrs. A. Petrie, a former 
St. Elizabeth visiting nurse demonstrated 
some of the prenatal exercises presently in 
use. 



District 5 



Ux BRIDGE 



Cottage Hospital 

Helen Hughes, former director of nurses 
at Cobourg District Hospital, has become 
superintendent of nurses of the new hospital 
in this area. The hospital opened in Janu- 
ary of this year. 

District 6 

Campbellfokd 

Memorial Hospital 

Vera B. Eidt was appointed director of 
nursing late last fall, following postgradu- 
ate study at the University of Toronto. Im- 
mediately prior to her university work Miss 
Eidt had been the director of nursing at the 
Trail-Tadanac Hospital. She is a graduate 
of the General Hospital, Guelph. 

SASKATCHEWAN 

Swift Current 

Ann Knievel has resigned as treasurer of 
the chapter and will leave the city shortly 
to become matron of the hospital at Ross- 
burn, Manitoba. Miss Antonini attended the 
January meeting from the SRNA provincial 
office and urged members to improve at- 
tendance at the annual convention to be held 
at the Bessborough Hotel, Saskatoon, May 
21, 22. Helen Talpash was appointed to re- 
present the chapter at a nomination com- 
mittee meeting to be held in Regina. Dr. F. 
Grunberg, director of the local mental health 
clinic, was the guest speaker and discussed 
the emotional aspects of hospitalization for 
mental patients. His audience participated in 
a lengthy discussion and question period, 
concentrated on the newer ideas in treatment 
of mental illness and the relationship between 
patient and nurse. 




THE NURSING CARE 

OF CHILDREN 

By Inez L. x\rmstrong. Director of 
Nurses, and Jane J. Browder, Educa- 
tional Director, both of Children's 
Hospital, Denver, Colorado. Designed 
for student nurses. $6.50. 

THE NURSE SPEAKS 

By Roy C. Nelson, Chairman, Depart- 
ment of English and Modern Lan- 
guages, Colorado State University. A 
guide for all the nurse's speech needs : 
both talking and public speaking. $4.25. 

DRUGS IN CURRENT USE 

Edited by Walter Modell, Cornell Uni- 
versity Medical College. Now available 
for 1959. $2.25. 

THE RYERSON PRESS 
299 QUEEN STREET WEST, TORONTO 



THE ALUMNAE 

ASSOCIATION OF THE 

GUELPH GENERAL 

HOSPITAL 

are offering a scholarship 
to a graduate of the 
School to undertake a 
Postgraduate University 
Course. 

For information apply to: 

MISS LILLIAN FERGUSON, 

CONVENER, 

SCHOLARSHIP COMMITTEE, 

42 DELHI STREET, 

GUELPH, ONTARIO 



MARCH, 1959 • VOL. 55, No. 3 



267 



Employment Opportunities 

Advertising Rates — $5.00 for 3 lines or less; $1.00 for each additional line. 
U.S.A. & Foreign — $7.50 for 3 lines or less; $1.50 for each additional line. 

Closing date for copy and cancellations : 1st of the month preceding the month of publication. 
All letters should be addressed to : The Canadian Nurse Journal, 1522 Sherbrooke St. W., 
Montreal 25, Quebec. 

Director of Nursing for new 33-bed General Hospital with well equipped surgery wing, in 
new mining town, about 250-ini. east of Port Arthur & northwest of White River, Ontario. 
Starting salary commensurate with experience & qualifications. Apply, stating qualifica- 
tions, experience, age, marital status, etc. to Mr. W. Harrison, Room 1715, 44 King Street 
West, Toronto, Phone EMpire 4-1194, or to the Administrator, Manitouwadge General 
Hospital, Manitouwadge, Ontario, Phone TAylor 6-3251. 

Director of Nursing for 180-bed hospital with a school of nursing. Applicant with University 
Degree &/or postgraduate course preferred. Salary commensurate with experience & 
qualifications, position available May 1959. Apply: Secretary, Board of Directors, Victoria 
Union Hospital, Prince Albert, Sask. 

Director of Nursing Education for 500-bed General Hospital with school of nursing. Appli- 
cant must have a degree in nursing. Salary commensurate with experience & qualifica- 
tions. Apply to, Director of Nursing, Royal Jubilee Hospital, Victoria, British Columbia. 
District Supervisor (after July 1, 1959) Responsibilities would include the supervision 
of three (3) small health centres. Existing salary range $4,140-$4,740 with a yearly 
increment of $150. A certificate in Administration & Supervision in Public Health Nursing 
& experience in an official agency are essential. Good personnel policies. 5-dy. wk. 
Superannuation, Ontario Hospital Insurance, Blue Cross & P.S.I, benefits. For further 
information please apply to Director of Public Health Nursing, City of Ottawa Health 

Dept., City Hall, 111 Sussex Drive, Ottawa, Ontario. 

Night Supervisor (8:00 p.m.-8:00 a.m.) 4 nights weekly for small Tuberculosis Hospital. 
Write stating age, experience, when available to Director of Nursing, Grace Dart Hospital, 

6085 Sherbrooke Street East, Montreal, Que. 

Obstetrical Supervisor for 10-bed 12-bassinet unit with 14-bed Woman's Surgical Unit 
on same floor. Willing to give Obstetrical Nursing lectures, clinics & supervise students. 
Medical staff teaches Obstetrics. Remuneration according to qualifications & experience. 
New school & residence under construction. Transportation allows easy access to 
Edmonton 40-mi. S.W. Travel expenses reimbursed after 1-yr. continuous service. Apply: 
Director of Nursing, Archer Memorial Hospital, Lamont, Alberta. 

Operating Room Supervisor, Operating Room General Duty Nurse for 110-bed modern 
hospital. Excellent personnel policies. Apply: Superintendent, Charlotte County Hospital, 
St. Stephen, New Brunswick. 

Operating Room Supervisor (Immediately) for 86-bed hospital. Good salary, employee 
benefits & statutory holidays, living accommodation available in residence. Locate in Col- 
lingwood & enjoy many winter sports along with excellent skiing in the Blue Mountains. 
Apply, Director of Nursing Se rvices, General <S Marine Hospital, Collingwood, Ontario. 
Operating Room Supervisor (Experienced in general surgery) for 64-bed hospital. Good 
personnel policies, with sick benefits; holidays & paid vacation. Residence accom- 
modation available. Salary commensurate with experience. Apply to Director of Nursing, 

Douglas Memorial Hospital, Fort Erie, Ontario. 

Operating Room Supervisor for active General Hospital in Niagara Peninsula. Post- 
graduate education required or background of supervisory experience. Apply: Director 

of Nursing, County General Hospital, Welland, Ontario. 

Operating Room Supervisor (Qualified) for 82-bed accredited hospital. Salary $295-$335 
per mo. 40-hr. wk. 21 holidays after 1-yr. of service (plus statutory holidays). Living accom- 
modation in separate nurses' residence & laundry of uniforms provided for $12 per mo. 

Apply: Superintendent of Nurses, Union Hospital, Carora, Saskatchewan. 

Nursing Supervisor for northern hospital. Good salary, good living conditions. Apply: The 

Matron, Yellowknife District Hospital, Yellowknife, North West Territories. 

Instructress willing to plan class room program <& teach. School enrollment 35-45 students. 
4 affiliation courses, block system lectures, new school of nursing & residence under 
construction. Remuneration according to qualifications & experience. Hospital 40-mi. 
N.E. Edmonton. Transportation permits for interests in Edmonton. Travel expenses re- 
imbursed after 1-yr. continuous service. Apply Director of Nursing, Archer Memorial 

Hospital, Lamont, Alberta. 

Superintendent of Nurses for modern 23-bed hospital, 40-hr. wk. salary range $310-$395 
per mo., board & room $34.50 per mo. Separate suite in new nurses' residence. 
Excellent train & bus connections with Prince Albert, Saskatoon & Regina. Apply giving 
qualifications to J. L. Fawcett, Sec. -Manager. Union Hospital, Rosthern. Saskatchewan. 
Matron for 18-bed hospital, salary $350 per mo. less $35 maintenance. X-ray & Lab. 
technician — reply salary expected based on experience. 70-mi. S.E. from Winnipeg. 
Daily bus service. Vita Hospital District No. 28, Vita, Manitoba. 

268 THE CANADIAN NURSE 



Matron: Salary $350 per mo. Registered Nurses (2) Basic salary $275 per mo. for 18-bed 
hospital. Residence available. 70-miles southeast of Winnipeg. Daily bus service. Apply: 
Vita Hospital District No. 28, Vita, Manitoba. 

Assistant Head Nurses excellent personnel policies. Apply Director, Shriners' Hospital for 

Cripp led Children, 1529 Cedar Avenue, Montreal, Quebec. 

Registered Nurse (1) Immediately for 30-bed hospital. Salary $260 per mo. gross, health 
& pension plans available. Straight 8-hr. rotating shifts. 44-hr. wk. 3-wk. vacation with 
pay after 1-year plus all statutory holidays. Within 1-hr. drive from Waterton National 
Park, 20 minutes from Lethbridge & 3-hr. from Calgary & Great Falls, Montana. Apply 
Matron, Municipal Hospital, Magrath, Alberta. ___^__ 

Registered Nurse for 35-bed busy General Hospital offers a variety of experience. 40-hr. 
wk., rotating periods of duty. Gross salary $270 per mo. $35 deducted for maintenance 
& laundry. 4 semi-annual increments of $5.00, 3-wk. vacation, 10 statutory holidays, 12 
days sick leave each year, cumulative to 30-days. Accommodation in hospital wing — 
single & double rooms. Viking is 90-mi. southeast of Edmonton, on main highway & 
railway with daily bus & train service. Apply to Matron-Supt., Municipal Hospital, 
Viking, Alberta. 

Registered Nurses (2) for modern 10-bed hospital. Working & living conditions excellent. 
Salary $260 per mo. with $5.00 increments each 6-mo. for 4 increases. 44-hr. wk. & 4-wk. 
vacation with pay after 1-yr. service. Living deduction $35 per mo. Apply to: Miss E. 
Curry, Matron, Nursing Unit, Pilot Mound, Manitoba. 

Registered Nurses for modern hospital, comfortable home. Starting salary $250 per mo. 
maintenance $35 per mo. Apply: Superintendent, Lome Memorial Medical Nursing Unit, 
Swan Lake, Manitoba. 

Registered Nurse for 11 -bed hospital. 4-wk. vacation after 1-yr. sick leave, living quarters 
at hospital. Apply stating experience <S salary expected to Secretary-Treasurer, Harvey 
Community Hospital, Harvey Station, New Brunswick. 

Registered Nurses; for 50-bed Hospital Obstetrical & General Duty. Rotating shifts, 40-hr. 
wk. Apply: Director of Nursing,, Ajax & Pickering General Hospital, Ajax, Ontario. 

Registered Nurses (for General Duty & Special Departments) new modern 1 50-bed 
hospital. Starting salary $235, 5-day wk., 8-hr. day, 21-days vacation, 8 statutory holidays 
& pension plan. Apply: Director of Nursing, St. Joseph's Hospital, Brantford, Ontario. 

Registered Nurses for General Duty modern 18-bed Private Hospital in Iron Mining town, 
180-mi. north of Sault Ste. Marie, Ont. Excellent accommodations & personnel policies. 
Starting salary $255 minimum to $290 maximum for experience, less $20 per mo. main- 
tenance. Transportation alowance after 3-mo. service. Apply Superintendent, Miss O. 
Keswick, Lady Dunn Hospital, Jamestown, Ontario. 

Registered Nurses for general duty in all departments — including operating room, pre- 
mature 5t newborn nursery. Good salary & personnel policies. Apply: Director of Nursing, 
Victoria Hospital, London, Ontario. 

Registered Nurses (Several) for immediate & future vacancies in modern 42-bed hospital, 
40-hr. wk. excellent personnel policies. Apply: Superintendent of Nurses, New Liskeard & 
District Hospital, New Liskeard, Ontario. 

Registered Nurses (2) for general duty. 5-day wk. 1-mo. vacation after 1-year. Salary 
$200 per mo. plus full maintenance. Apply, Saugeen Memorial Hospital, Southampton, 
Ontario. ^^^ 

Registered Nurses (Toronto Area) for 30-bed hospital for chronic illnesses. Salary $12 
per day; 5-day wk.; 3-wk. vacation per year. Apply: L. Mackie, Director of Nursing, The 

Villa Private Hospital, Box 490, Thornhill, Ontario. 

Registered Nurses for Operating Room & general staff positions. Salary $245 per mo. 
5-day wk. Excellent residence accommodation available. Apply: Director of Nursing, 

County General Hospital, Welland, Ontario. 

Registered Nurses for an accredited 82-bed hospital. Salary: $255-$295 per mo. 40-hr. wk. 
& no split shifts. Living accommodation in nurses' residence & laundry of uniforms provided 
for $8.00 to $12.00 per mo. Apply: Superintendent of Nurses, Union Hospital, Canora, 
Saskatchewan. 

Registered Nurses for general duty work. 40-hr. 5-day wk. Salary according to S.R.N. A. 
recommendations. Apply Superintendent of Nurses, Victoria Union Hospital, Prince Albert, 
Saskatchewan. 

Registered Nurses (2) for 19-bed hospital. Gross salary $260 with increments & benefits as 
per S.R.N. A. Nurses' residence on grounds with T.V. Apply: Union Hospital, Vanguard, 
Saskatchewan. 

Registered Nurses (Openings in all services) for 166-bed JCAH fully accredited General 
Hospital, expanding to 374-beds by 1960. Top salaries, many extra benefits & oppor- 
tunities for advancement. Excellent personnel policies. Located on beautiful San Fran- 
cisco Peninsula, 20 minute drive from the heart of the city. Apply Personnel Director, 
Peninsula Hospital, Burlingame, California. 

MARCH, 1959 • VOL. 55, No. 3 269 



Registered Nurses: Positions available in all areas & on all shifts. Ultra modern, new 
254-bed General Hospital located in the heart of beautiful sunny Castro Valley, just 30 
minutes drive from San Francisco. This is a busy residential community which offers 
casual California living at its very best. Many excellent schools & colleges within easy 
commuting distance. Progressive personnel policies include free hospital & surgical in- 
surance, paid sick leave, paid vacations, 7 recognized holidays & other benefits. No split 
shifts; evening & night duty salary differential, also differential paid for operating room, 
delivery room & nursery service. Uniforms laundered free. Basic salary for general staff 
duty, $320 per mo. Salaries for other positions commensurate with assignments. Please 
write: Personnel Manager, Eden Hospital, 20103 Lake Chabot Road, Castro Valley, Calif. 
Registered Nurses (eligible for registration in California) Come to the Los Angeles 
County General Hospital. Openings in all services. Starting salary $372 per mo. 3-11:30 
or 11-7 shift. We have openings for Assistant Head Nurses. Medical Service. Starting at 
$412 per mo. 3-11:30 shift. For full details, write: Mrs. Betty Hartwig, R.N. County General 
Hospital, 1200 North State Street, Los Angeles 33, California. 

Registered Nurses for new 157-bed General Hospital located in fast growing City of 
Fremont approximately 1-hr. from heart of San Francisco. Good salary, vacation, sick 
leave & hospitalization plan. Contact Director of Nursing Services, Washington Township 

Hospital, P.O. Box 656, Niles, California. 

Registered Nurses for General Duty & Operating Room. Starting salary $325 per mo. 
40-hr. wk. Living quarters available. Modern 74-bed district hospital, midway between 
San Francisco & Los Angeles, California. Contact Administrator, District Hospital, 

Tulare, California. 

Registered Nurses: Spend your winter in the Sunny Southwest — New Mexico, "The land 
of Enchantment". Vacancies for staff duty in Medicine, Surgery, Obstetrics, Pediatrics, 
and Operating Room. Salaries $285-$315, days; $10 differential for evenings & nights; 
$15 differential, operating room. No shift rotation. Excellent job benefits. Board and room 
in nurses' residence, $43 per month. Free transportation via 1st Class Air travel to Albu- 
querque and return in exchange for a 1-yr. employment contract. Write or call collect 
Mrs. Margaret Nelson, Director of Nursing, Presbyterian Hospital Center, 1012 Gold Ave. 

S.E. Albuquerque, New Mexico. Phone 3-5611. 

Registered Nurse (1) immediately for Margaret Cochenour Memorial Hospital (modern 
15-bed) located on the lake in Red Lake mining district & tourist area. New nurses' resi- 
dence beautifully furnished. Salary: $275 basic with increment plan. Maintenance includ- 
ing uniform laundry, $30 per mo. 44-hr. wk. Holidays. 4-wk. vacation with pay yearly. 
Transportation expense will be paid after 6-mo. employment. Apply, stating age & ref- 

erences to I. MacNaughton, Matron, Cochenour, Ontario. ^__ 

Registered Nurses (2) Practical Nurses (2) for modern 20-bed hospital. Salary-registered 
$290 practical $195 less $35 maintenance. 40-hr. wk. 4-wk. vacation after 1-year service. 
Statutory holidays & sick leave. Registered to start April 1, practicals May 1. Apply to 

Memorial Hospital, Deloraine, Manitoba. 

Registered Nurses (2) Licensed Practical Nurse (1) for 15-bed hospital under the United 
Church of Canada, 90-mi. north of Winnipeg, salary $270 per mo. gross. Apply to: Super- 
intendent, Elizabeth M. Crowe Memorial Hospital, Eriksdale, Manitoba. 

Registered Nurse (1). Licensed Practical Nurse (1) as soon as possible for 30-bed hospital. 
Excellent working conditions. 40-hr. wk., overtime pay, living quarters. Salaries $270 & $195 
per mo. respectively with $5.00 increases every 6-mo. Apply stating age & qualifications to, 
Mrs. R. Maiers, Superintendent, District Hospital, Roblin, Manitoba, or phone 180 collect. 
Registered Nurses & Licensed Practical Nurses for new 33-bed General Hospital with well 
equipped surgery wing, in new mining town, about 250-mi. east of Port Arthur & northwest 
of White River, Ontario. Starting salary commensurate v/ith experience & qualifications. 
Apply: stating qualifications, experience, age, marital status, etc. to Mr. W. Harrison, Room 
1715, 44 King Street West, Toronto, Phone EMpire 4-1194, or to Administrator, Manitouwadge 

General Hospital, Manitouwadge, Ontario, Phone TAylor 6-3251. 

Registered Nurses & Certified Nursing Assistants for new expanding 88-bed hospital in a 
pleasant progressive town. General Duty Registered Nurses start $220, annual increments 
to $240, Certified Nursing Assistants $150, annual increments to $180. 2-wk. shift rotation, 
bonus for 4-12 & 12-8 shifts. Accumulated sick leave to 60-dy. Only 1-hr. drive to Toronto, 
to other cities <S resort areas. Local swimming pool, artificial ice arena, bowling, etc. Apply: 

Director of Nursing, Dufferin Area Hospital, Orangeville, Ontario. 

Registered Nurses for Operating Room with operating room postgraduate courses and/or 
experience, for 140-bed hospital. Travel allowance paid. For particulars, write Matron, 

King Edward VII Memorial Hospital, Bermuda. 

Registered Nurses for General Duty Staff. Salary commences at £40-10-0 per mo. with full 
maintenance. Transportation allowance. For full particulars apply Matron, King Edward 
VII Memorial Hospital, Bermuda. 

Registered Nurses for General Staff & Operating Room in modern hospital (opened in 1956). 
Situated in the Nickel Capital of the world, pop. 50 000 Salary: $260 per mo. with semi- 
annual merit increments, plus annual bonus plan. Recognition for experience. Excellent 
personnel policies. Assistance with transportation can be arranged. Apply Director of 
Nursing, Memorial Hospital, Sudbury. Ontario. 

270 THE CANADIAN NURSE 



Registered General Duty Nurses & Licensed Practical Nurses. Salary, Registered Nurses 
$250-$284 per mo. (Evening duty $10 additional) Practical Nurses $194-$215 per mo. 
40-hr. wk. statutory holidays, liberal sick time, holiday allowance, pension plan, accom- 
modation available in nurses' residence, uniforms laundered free. Must qualify for 
Manitoba registration. Apply: Director of Nursing, Municipal Hospitals, Morley Avenue 

East, Winnipeg 13, Manitoba. 

Registered General Duty Nurses. Salary: $230 per mo. 40-hr. wk. Apply Director of Nursing, 

General Hospital, Cobourg, Ontario. 

Registered General Duty Nurses (Immediately) for 100-bed Public Hospital in eastern 
Ontario. 44-hr. wk., 2-wk. sick leave, 3-wk. annual vacation. Apply, Superintendent, Public 

Hospital, Smiths Falls, Ontario. 

Registered General Duty Nurses for County Hospital 45-mi. from center of Montreal 
with excellent bus service. Pleasant working conditions. Nurses' home attached to 
hospital. Attractive community social life. Theatre, bowling, curling & dancing. 8-mi. 
from summer resort on Lake St. Francis & 12-mi. from U.S. border. Gross salary $225. 
Three $5.00 increases at 6-mo. intervals to maximum $240, 44-hr. wk. 8-hr. duty, rotating 
shifts. Full maintenance available at $35 per mo. 1-mo. annual vacation, 7 statutory 
holidays, 2-wk. sick leave. Blue Cross paid. Apply: Mrs. M. G. Curran, R.N., County 

Hospital, Huntington, Quebec. 

Registered General Duty Nurses for 154-bed General Hospital with expansion program 
under way. Along the shores of Lake Michigan, 25 mi. from Chicago. Salary: $340 for days, 
$370 for evenings, $360 for nights, 5 day wk. Good personnel policies. Apply Personnel 

Director, Highland Park Hospital Foundation, 718 Glenview Ave., Highland Park, 111. 

Registered General Duty Nurses (100-bed) Good bedside nursing required, 40-hr. wk. 
rotating duties. Excellent personnel policies. You arrange for R.I. State Registration. Apply: 
Nurse Director, Jane Brown Memorial Hospital, Providence 3, Rhode Island. 
Registered & Graduate Nurses for General Duty. Apply, Superintendent of Nurses, Mus- 

koka Hospital, Gravenhurst, Ontario. 

General Duty Registered Nurses for 100-bed General Hospital in town of 6000 on shore 
of Lake Huron. Good personnel policies, 5-day wk., residence accommodation available. 
Please apply to Superintendent, Alexandra Marine & General Hospital, Goderich, Ont. 
Baker Memorial Sanatorium, Calgary, Alberta, offers to Graduate Nurses a 6-mo. post- 
graduate course in Tuberculosis. Salary: $3,480 to $4,080 per annum. Openings also avail- 
able for General Duty Nurses. Residence with board, if desired, $30 per mo. Excellent 
holiday, sick leave & pension benefits. Apply to: Superintendent of Nurses. 
General Duty Nurses- $210 per mo. plus full maintenance. $5.00 per month increase 
every 6-mo. 1-mo. vacation with pay after 1-year. Please apply- Matron, Municipal 

Hospital, Raymond, Alberta. 

General Duty Nurses for small active hospital. Salary $250 for unregistered. $260 registered 
with yearly increments. Nurses' Home available. For further particulars write. The Adminis- 

trator, Lady Minto Hospital, Ashcroft, British Columbia. 

General Duty Nurses for R. W. Large Memorial Hospital United Church of Canada at Bella 
Bella 300-mi., north of Vancouver on B.C. Coast. Transportation refunded after 1-yr., Apply 

to. Matron, R. W. Large Memorial Hospital, Bella Bella, British Columbia. 

General Duty Nurses for new 60-bed acute General Hospital on Vancouver Island 
R.N. A. B.C. contract in effect, new residence, good personnel policies. Further information 
from Director of Nursing, Campbell River & District General Hospital, Campbell River, 
British Columbia. 

General Duty Nurses (2) for modern 17-bed hospital in beautiful country on west coast 
of Vancouver Island. Salary commencing $275 with yearly increments of $10, room & 
board in newly completed nurses' residence $40 per mo. Apply to Matron, General 
Hospital, Tofino, British Columbia. 

General Duty Nurses: Starting salary $260 — $312, for those with 2 yrs. nursing experience 
$273, annual increment $13, full maintenance $45 per mo., 10 statutory & 28 annual holidays, 
IV2 days' sick leave per mo. accumulative indefinitely, very active town, world famous 
Cariboo cattle country, annual Stampede. Apply: Director of Nurses, War Memorial Hos- 
pital, Williams Lake, British Columbia. 

General Duty Nurses for new 85-bed hospital. Good salary & generous personnel policies. 
Apply to the Director of Nursing, Portage Hospital Dist. #18, Portage la Prairie, Manitoba. 

General Duty Nurses for modern 35-bed hospital situated on beautiful South Shore. Good 
personnel policies. Excellent living quarters. Apply Superintendent, Fishermen's Memorial 
Hospital, Lunenburg, Nova Scotia. 

General Duty Nurses for an accredited 64-bed hospital. Starting salary: $250-$260. Good 
personnel policies with sick leave benefits, holidays & paid vacations. Apply Director of 
Nursing, Douglas Memorial Hospital, Fort Erie, Ontario. 

General Duty Nurses (immediately) for 105-bed General Hospital. Salary $220 per mo. 
with annual increments of $10 per mo., 40-hr. wk., 21 days vacation after 1-yr. 31 days after 
2-yr. Room, board & laundry $35 per mo. Apply: Director of Nursing, St. Andrews Hospital, 
Midland, Ontario. 

MARCH, 1959 • VOL. 55, No. 3 271 



General Duty Nurses for modern 42-bed hospital, starting salary, new graduates $255 with 
two (2) yr. experience $270 provided Ontario registration is obtained; these rates to be 
revised October 1st. Ontario registration required ior maximum salary. Annual increments, 
6% bonus for evening & night shifts. 44-hr. wk. with 8 statutory holidays, annual vacation 
21 days first yr. 28-dy. thereafter, monthly sick time allowance. Good living accommoda- 
tions available. Apply to: Nursing Supervisor, Sioux Lookout General Hospital, Sioux 
Lookout, Ontario. 

General Duty Nurses (English speaking) for 466-bed hospital. Nurses' residence available. 
Salary: $315, California registered — $285, Canadian registered. $22.50 differential for 3-11 
& 11-7 shifts. Apply Cedars of Lebanon Hospital, 4833 Fountain Ave., Los Angeles, Calif. 
General Duty Nurses (California, between Sacramento & San Francisco) for 84-bed general 
short term JCAH hospital. Starting salary $325, nurses' home, excellent working conditions. 
Write, Director of Nurses, Clinic Hospital, Woodland, California. 

McKellar General Hospital, Fort William, Ontario requires General Duty Staff Nurses 
interested in coming to northwestern Ontario. Basic salary, $250 per mo. 40-hr. wk. Good 
personnel policies. Renovation program now complete. Openings in all departments. For 
further information apply to the Director of Nursing. 

General Duty Nurses & Operating Room Nurses for 434-bed hospital; 40-hr. wk. Statutory 
holidays. Salary $250-$312. Credit for past experience & postgraduate training. Annual 
increments; cumulative sick leave; 28 days annual vacation; B.C. registration required. 
Apply Director of Nursing, Royal Columbian Hospital, New Westminster, B.C. 
General Duty Nurses, O.R. Scrub Nurse (For Summer Relief) in modern well equipped 
100-bed General Hospital in a friendly community. Gross Salary $260 per mo. for nurses 
currently registered in Ontario. 8-hr. rotating shifts, 44-hr. wk. 1 day off 1-wk. & 2 the next; 
21 days vacation after 1-yr; 7 legal holidays per yr. Apply: Miss Willamene R. Allan, Reg.N. 
General Hospital, Port Colborne, Ontario. 

General Duty Nurses <S O.R. Scrub Nurses for 1 42-bed hospital. Basic salary $235 per 
mo. shift differential, 40-hr. wk. good personnel policy. Apply: Director of Nursing, 
Plummer Memorial Public Hospital, Sault Ste M arie, Ontario. 

General Duty Nurses & Certified Nursing Assistants for 86-bed hospital. Living accommo- 
dation available. Collingwood is situated on Georgian Bay & is noted as a vacation land 
in summer with 7-mi. of sand beach, along with great skiing on the Blue Mountains in 
winter. For further information apply Director of Nursing Services, General & Marine 
Hospital, Collingwood, Ontario. 

General Duty Graduate Nurses for an active 76-bed hospital near Calgary & Banff. $250 
gross salary, $260 for Alberta registered, good personnel policy. Apply to Matron, Brooks 
Municipal Hospital, Brooks, Alberta. 

General Duty Graduate Nurses (2). Salary $260 per mo. with annual increments of $10 per 
mo. Room, board & laundry: $40. 28-day vacation after 1-yr. service. All statutory holidays 
paid. Customary sick leave. Graduate complement, 5. Apply giving full details to Matron, 
Slocan Community Hospital, New Denver, B.C. 

Graduate Nurses for 70-bed General Hospital. Salary $260-$280; 5-day wk., 28 days vaca- 
tion plus 10 statutory holidays, after 1 yr. Apply: Matron, St. George's Hospital, Alert Bay, 
British Columbia. 

Graduate Nurses for 110-bed hospital. General duty & operating room positions avail- 
able. $283 per mo. $15 extra for P.G. Usual B.C. personnel policies. Room & board $50. 
For more particulars apply to Director of Nursing, General Hospital, Prince Rupert, 
British Columbia. 

Graduate Nurses; for new 63-bed hospital, 30 miles from Vancouver in the Fraser Valley. 
For Salary rates & Personnel policies. Apply: Director of Nursing, Maple Ridge Hospital, 
Haney, British Columbia. 

Graduate Nurses for 37-bed hospital, salary $250 per mo. with annual increments — 28-dy. 
annual vacation, cumulative sick leave. $50 monthly board, lodging, laundry. New 
50-bed hospital to be erected 1959. Apply: Administrator, Terrace & District Hospital, Box 
1297, Terrace, British Columbia. 

General Staff Nurses for 400-bed Medical & Surgical Sanatorium, fully approved student 
affiliation & postgraduate program. Full maintenance. Recreational facilities. Vacation 
with pay. Sick benefits after 1 yr. Blue Cross coverage. Attractive salary; 40-hr. wk. For 
further particulars apply Supt. of Nurses, Nova Scotia Sanatorium, Kentville, N.S. 

General Staff Nurses for 300-bed approved hospital & school of nursing. Salary $250 per 
mo. plus $10 & $5 for pm & night differential. Annual increment for 3-yr. 8-hr. day; 5-day 
wk; 3-wk. vacation; pension plan; sick time allowance; 8 statutory holidays; partial pay- 
ment of health plan. Apply: Director of Nursing, St. Thomas-Elgin General Hospital, St. 
Thomas, Ontario. 

General Staff Nurses for 370-bed approved General Hospital with intern & resident pro- 
gram. $315 per mo. starting salary. $15 per mo. merit increases at 12, 24 & 36 mo. 40-hr. wk. 
2-wk. paid vacation, paid sick leave, 7 paid holidays. Pleasant coast city in outstanding 
recreational area. Apply Director of Personnel, Seaside Memorial Hospital, Long Beach 13, 
California. 

272 THE CANADIAN NURSE 



DIRECTOR 

SCHOOL OF NURSING 

SOUTHWESTERN ONTARIO RESORT AREA 

Excellent position available June 1959. Modern classrooms & facilities located in main 
wing of hospital. Student enrollment 83. New student's residence adjacent to hospital. 
Minimum qualifications include a bachelor's degree in Nursing Education, as well as 
successful experience in Nursing Administration & Education. Registration in Ontario 
is required. The person appointed to this position will have the opportunity of using 
progressive techniques in teaching. 

WRITE TO BOX 0, THE CANADIAN NURSE JOURNAL, 1522 SHERBROOKE STREET WEST, 
MONTREAL 25, QUE., FOR ADDITIONAL DETAILS. 



General Staff Nurses for fully accredited private teaching hospital, located on Lake 
Michigan just north of Chicago. 5-day, 40-hr. wk. Salary range $337.35 to $363.30. Shift 
bonus: $26 afternoons & $17 nights. Progressive personnel policies. Please indicate type of 
service preferred. Apply: Director of Nursing, Evanston Hospital, 2650 Ridge Avenue, 
Evanston, Illinois. 

Staff Nurses (3 immediately) for 18-bed Community Hospital in scenic setting in the heart 
of the Canadian Rockies. Starting salary $250 per mo. Full maintenance available in 
modern nurses' residence. For full particulars write: C. F. Collins, Secretary, General Hos- 
pital .Golden, British Columbia. 

Staff Nurses 600-bed general & tuberculosis teaching institution in central valley City. 

Accredited State & Junior Colleges in immediate vicinity, Liberal personnel policies. 

Salary $320-$360. Full maintenance available. Write — Director of Nursing Service, Fresno 

County General Hospital, Fresno 2 California. 

Staff Nurses for 300-bed General Hospital. Attractive personnel policies plus differential 

for specialties, afternoon & night duty. Opportunities for advanced education. Apply to 

Director of Nursing Service, Kaiser Foundation Hospital Oakland 1 1 . California. 

Staff Nurses (All services) Texas teaching hospital. Air conditioned; good personnel 

policies. Base salary-rotation $290 per mo. Evenings or night $304 per mo. Apply: 

Director of Nursing Service, University of Texas Medical Branch, Galveston, Texas. 



STAFF NURSES 

Starting salaries range from $300-$330 per 

mo. depending on previous experieiice. 

Nurses agreeing to work 3 continuous 

months of evenings will receive in addition 

a bonus of $15 per wk. Nurses agreeing to 

work 3 continuous months of nights will 

receive a bonus of $10 per wk. 

Call: 

MISS BEATRICE STANLEY, 

DIRECTOR OF NURSING SERVICE, 

STRONG MEMORIAL HOSPITAL, 

ROCHESTER, NEW YORK. 

PHONE GREENFIELD 3-4400 



THE ONTARIO SOCIETY 
FOR CRIPPLED CHILDREN 

92 College St., Toronto 2 

requires 

Experienced Public Health Nurses 

Good salary ranj^e & personnel policies 

Apply: 
Supervisor of Nursing Services 



REGISTERED NURSES 

FOR THE OPERATING ROOM, OBSTETRICAL AND MEDICAL 
SURGICAL UNITS OF A 350-BED GENERAL HOSPITAL 

Gross salary $250 — $280 per month if registered in Ontario. 

Differential of $10 for evening and night duty. 

40-hour week. Sick leove accumulative to 30 days. 

3 weeks vacation and eight statutory holidays. 

Apply. 

DIRECTOR OF NURSING SERVICES, METROPOLITAN GENERAL 
HOSPITAL, WINDSOR, ONTARIO. 



MARCH. 1959 • VOL. 55. No. 3 



273 



Operating Room Nurse for i06-bed hospital. New hospital & nurses' residence to be com- 
pleted this year. For information regarding duties & salary please write to the Director ol 
Nursing, Prince George & District Hospital, Prince George, British Columbia. 
Public Health Nurse (qualified) for completely generalized program. Salary range, pension 
plan & other personnel policy given on request. Applicant must have car. Apply to Dr. 

Bert Cross, Muskoka District Health Unit, Bracebridge, Ontario. 

Public Health Nurse for generalized program in Seaway Development area. Good 
transportation policy & pension plan. Apply to Mr. L. C. Kennedy, Secretary-Treasurer, 
Board of Health, Stormont, Dundas & Glengarry Health Unit, County Buildings, Cornwall. 

Ontario. 

Public Health Nurse (Qualified) minimum salary $3,200; allowance for experience. $150 
annual increments; 5-day week; 4-wk. vacation; sick leave credits; Blue Cross, pension 
plan, car allowance. Financial assistance towards purchase of car. Apply to Mr. A. F 
Stewart, Secretary-Treas., Wentworth County Health Unit, Court House, Hamilton, Ontario. 
Public Health Nurses: required in a generalized program in rural & semi-urban area 
adjacent to metropolitan Toronto. Excellent working conditions including pension plan, 
group insurance & transportation arrangements. Write: Dr. R. M. King, York County Health 
Unit, Newmarket, Ontario. 

Certified Nursing Assistants for immediate vacancies in an accredited 64-bed hospital. 
Starting salary $180 per mo. Good personnel policies with sick leave benefits. Holidays 
& paid vacations. Apply to Director of Nursing, Douglas Memorial Hospital, Fort Erie, Ont. 
"STOP! IS THIS WHAT YOU ARE LOOKING FOR?" Applications are invited for positions 
on the permanent or "vacation relief" Staff of a 50-bed active hospital 35-mi. from 
Vancouver. R.N. A. B.C. Personnel Policies in effect. Apply to Director of Nursing, Langley 

Memorial Hospital, Murrayville, British Columbia. 

Instructor, medical & surgical nursing. Apply, stating qualifications & experience, to 

Director of Nursing, Women's College Hospital, Toronto 5, Ontario. 

Nurses (2) immediately for 20-bed hospital, 40-hr. wk. Wages $285 plus annual raises; 
4-wk. vacation after each years service. Living in quarters available. Apply to Matron, 

Coronation Municipal Hospital District No. 39, Coronation, Alberta. 

General Staff Nurses are needed to help us open our new wings. Operating room, 
recovery room, surgical & medical wards will be the first units available for use in the 
near future. Well planned orientation & in-service program, good personnel policies. 
Apply Director of Nursing, Toronto East General Hospital, Toronto 6, Ontario. Telephone 

HO. 1-8272, Local 345. 

General Duty Nurses for new 20-bed hospital. Salary $270 per mo. Accommodation avail- 
able at new nurses' residence. For further particulars apply to Matron, Municipal Hospital 

District No. 72, Bow Island, Alberta. 

Registered Nurses for College town of 10,000; opportunity, college study. Salaries $290- 
$310. 40-hr. wk. holidays, sick time, vacation. Blue Cross & Social Security. Apply: Callaway 
Memorial Hospital, Fulton, Missouri. 

Registered Nurses (2) as soon as possible for 16-bed hospital. Salary $280 per mo. gross, 
$40 per mo. deducted for board 6c room. 40-hr. wk. 3-wk. vacation with pay after 1 full year 
employment 4-wk. after 2 full years. Sick leave one day for each full month of employment 
plus 1 day for each full 6-mo. employment cumulative to 30 days. Living quarters in hos- 
pital. Apply to A. C. Laughlin, Secretary, Wilson Memorial Hospital, Melita, Manitoba. 

Registered Nurses (Immediately) for general duty, salary $250 per mo. with $5.00 increase 
semiannually for first year plus $10 increase annually for next 2 years. Apply: Superinten- 

dent, Little Long Lac Hospital, Geraldton, Ontario. 

Registered Nurses for General Staff 38-bed General Hospital. Personnel policies good. For 
further information, contact: Administrator, City Hospital, Red Wing, Minnesota. 

Registered General Duty Nurse for 30-bed hospital. Starting salary $260 per mo. with $10 
yearly increment. Board & room $40, U/a day sick leave per mo. 40-hr. wk. 11 statutory 
holidays & 28 days vacation after 1-yr. service. Comfortable nurses' residence next door to 
hospital. Rotating shifts. Please apply to; The Matron, Community Hospital, Grand Forks, 
British Columbia. 

General Duty Nurses for 100-bed hospital with a school of nursing. Hospital 40-mi. north- 
east of Edmonton. Transportation allows for activities in Edmonton when desired. New 
residence under construction. Travel expenses reimbursed after l-yr. continuous service. 
Remuneration according to qualifications & experience. Apply: Director of Nursing, Archer 
Memorial Hospital, Lamont, Alberta. 

Registered General Duty Nurses for modern hospital, building expansion under way 
increasing to 100-beds this year. Salary $250 per mo. to start, $215 for graduates. Group 
life, accident & sickness insurance free to employees. Opportunities for advancement. 
Pleasant community. Apply: Director of Nursing, District Memorial Hospital, Leamington, 
Ontario. 

POSITION WANTED 

Science Instructor for September or October, 1959. Please write to Box E, The Canadian 
Nurse Journal, 1522 Sherbrooke Street West Montreal 25, Quebec. 

274 THE CANADIAN NURSE 



DAUPHIN 

GENERAL HOSPITAL 

SCHOOL OF NURSING 

PERSONNEL WANTED 

1. DIRECTOR 
OF NURSES: 

Qualifications Preferred : Degree 
in Nursing or Postgraduate Course 
in Nursing Administration with 
experience in a hospital operating a 
School of Nursing. Duties to com- 
mence as soon as possible. 

2. DIRECTOR OF 
SCHOOL OF NURSING: 

This position offers a real challenge 
for the person who will be chosen. 
Duties involve the organizing and 
directing of the School of Nursing. 
Qualifications preferred : Degree in 
NTursing including preparation for 
teaching. Duties to commence not 
later than July 1. 1959 ; earlier if at 
all possible. 

3. INSTRUCTOR TO 
TEACH SCIENCE 
SUBJECTS: 

Degree in nursing or University 
preparation for teaching in nursing 

Normal complement of Training 
School — 35 to 40 students. Excellent 
personnel policies. Salaries open. New 
and renovated 100-bed hospital in thi- 
planning stage. Hospital located in 
beautiful town of 7,000 immediately 
north of the Riding Mountain National 
Park. Four hours from Winnipeg on 
all-wenther highway. 

Apply to: 

A. J. Schniiedl, Administrator, 

DAUPHIN GENERAL HOSPITAL 

DAUPHIN, MANITOBA 




Live and work in New Yorl( City 

BE ASSOCIATED WITH 

ONE OF AMERICA'S 

LARGEST RESEARCH 

HOSPITALS 

• opportunity to work in 
area of your choice 

• Keep abreast of latest 
trends in nursing 

• Work in creative 
atmosphere 

• No rotation of shifts 

• 4 weeks vacation 

• 1 1 paid holidays 

• Excellent Living 
Quarters 

• Nursery school avail- 
able for children 
of R.N. 's 

• Other benefits including 
life insurance, Blue 
Cross, liberal sick 
leave, and pension 

VISA CLEARANCE AND 
TRANSPORTATION 
WILL BE ARRANGED 

Write or Call 
Personnel Dept. 



IWcmJtefXo^ 



HOSPITAL 



210 St. & Bainbridge Avenue 
New York 67, N. Y. Olinville 2-7787 



MARCH. ia-i9 • VOL .55. No .3 



275 



THE B.C. CIVIL SERVICE 

Requires 
PUBLIC HEALTH NURSES GRADE 1 

Positions available for qualified Public Health Nurses in various centnes in B.C. 
Salary: $290 rising to $345 per month; car provided. 

An opportunity for interesting and chalJenging professional service in this 
beoutiful and fost-developing province. 

For information and opplicaiion forms, write: 

THE DrRECTOR, PUBltC HEALTH NURS1t<K;, DEPARTMENT OF HEALTH, VICTORIA, B.C. or 
THE CHAIRMAN, B.C. C1V41 SERVICE COMMISSION, 544 MICHIGAN STREET, VICTORIA, B.C 

CompetUion No. 59:67 



DIRECTOR - SCHOOL OF NURSING 

For a School of 90-students, organized independently of Nursing Services. 

The school program foHows the pattern of 2-years of nursing education phis 

1-year of internship. 

Salary: $5,1 00 - $5,700 per annum. 

Requirements: Degree & experience in the administration of a nur&ing educo- 

tion program. 

Appi/ to: R. Buckner, Administrator, 

Metropolitan General Hospital, 
Windsor, Ontario. 



REGISTERED NURSES — $3,000-$3,540 

(According to Qualifications) 

CERTIFIED NURSING ASSISTANTS — $2,040-$2,400 

SUNNYBROOK HOSPITAL WESTMJNSTER HOSPITAL 

TORONTO LONDON 

Employees in both hospitals work a 5-day week. 
AppKcotion forms ovailoble at your nearest Civil Service Commission Office, or main Post OffKes, 
should be forwarded to the CIVIL SERVICE COMMISSION, 25 ST. CLAIR AVENUE EAST, 
TORONTO 7, as soon c»s possible. 



GENERAL DUTY NURSES 

(Graduates) for U.S.A. 

236-bed hospital. 30 miles from New 
York City. Apt. style residence. Good 
salary. Free benefits. Pension plan. 

Apply: 

DIRECTOR OF NURSING, 

MEMORIAL HOSPITAL, MORMSTOWN, 

NEW JERSEY, U.S.A. 



NURSING POSITIONS 
AVAILABLE 

Starting salary $300-$340 per mo; 40-hr. wk., 
4-wk. vacation; 2-wk. sick time allo>Aronce; 
health insurance; living accommodation in 
nufses' residence; evening & night bonus 
$40-$30 per mo.; tuition aid for advanced 
education in nearby universities. 

Lenox HitI Hospital is a large General Hospital 
in the heart of Manhatton, easily cKcessibJe to 
the cultural advantages of the large metropolis. 

Write: 

DIRECTOR OF NURSING, 

LENOX HILL HOSPITAL 

76th STREET & PARK AVENUE 

(MIDTOWN NEW YORK) 



276 



THE CANADIAN NURSE 



WWAJ DO you WAUT 

FROM your^ ummG c^r^EER? 




n 



Q chance to learn more, 
and grow into a posi- 
tion of responsibility. 



D 



working with top sur- 
geons, physicians, 
nurses and technicians. 



n 



a chance to test your- 
self in o variety of 
nursing positions. 



D 



friendly supervision, 
with a spirit of mutuol 
helpfulness. 




on opportunity to take 
port in a progressive, 
human approach to 
medical care. 



modern, comfortable 
surroundings, brand 
new cafeteria. 



living in on interesting, 
large city, with an 
immense variety of 
entertainment, sports, 
cultural events. 



D 



friendly, interesting 
componionship in your 
work. 



These are just a few of the advantages of working 
at Cleveland Clinic Hospital. Others include top 
starting pay (salaries begin at $325), 40 hour week, 
insurance, pension plan, tuition-free graduate edu- 
cation, and many other benefits. 

If you are about to graduate from nursing school, 
and want to plan your career with the utmost care, 
write for our free booklet, "Nursing at Cleveland 
Clinic Hospital." 



CLEVELAND CLINIC HOSPITAL 

2020 EAST 93RD STREET 
CLEVELAND 6, OHIO 

I 1 

Cleveland Clinic Hospital, 2020 E. 93, Cleveland 6, Ohio 

□ Please send me your free booklet. 
"Nursing at Clevelarui Clinic Hospital." 

□ Please send an application farm 



City & State 



MARCH, 1959 • VOL. 55, No. 3 



277 



UNIVERSITY HOSPITAL 

SASKATOON, SASKATCHEWAN 

Requires 
General Staff Nurses for Medical, Surgical, Obstetrical and Pediatric Services. 
Forty hour week. Salary $250 to $290 gross per month. Differential for 
evening and night duty. Residence accommodation if desired. 

Apply /o. 

DIRECTOR OF NURSING, UNIVERSITY HOSPITAL, 

SASKATOON, SASKATCHEWAN 



GRADUATE STAFF NURSES — YOU WILL LIKE IT HERE 

Opportunities for men & women on the service of your choice. A 953-bed 
teaching hospital with a friendly atmosphere, well planned orientation pro- 
gram, active graduate nurse club, cultural advantages & excellent transpor- 
tation facilities. 
Starting salary: $325 per mo. 6 holidays, sick leave, 3 wk. vacation. 

For further details write: 
Director — Nursing Service, University Hospitals of Cleveland, Ohio. 



SUBURBAN TORONTO 

GRADUATE NURSES & CERTIFIED NURSING ASSISTANTS 

Are invited to enquire re: employment opportunities in a well staffed new 
125 bed hospital in suburban west Toronto. General duty salary range: 
$255-$305 per mo. Certified Nursing Assistants $190-$210 per mo. Residence 
accommodation optional. Personnel manual forwarded on request. Enquire to: 

DIRECTOR OF NURSING, NUMBER MEMORIAL HOSPITAL, 200 CHURCH STREET, WESTON, 
TORONTO 15, ONTARIO — CH 4-5551 



GENERAL DUTY NURSES 

FOR ALL DEPARTMENTS 

Gross salary $255 monthly ($1 17.50 bi-weekly) if registered in Ontario, $235 
monthly ($108.20 bi-weekly) until registered. Annual increment $10 monthly 
($4.60 bi-weekly) for three (3) years. Rotating periods of duty, 40-hr. per wk., 
8 statutory holidays. 14-days vacation & 1 2-days leave for illness with pay after 
1-yr. Pension plan available. Ontario Hospital Insurance with Blue Cross 
supplemental & Physicians' Services Incorporated, partial payment by hospital. 

APPLY 
DIRECTOR OF NURSING, GENERAL HOSPITAL, OSHAWA, ONTARIO. 



278 THE CANADIAN NURSK 



428 WEST 59th STREET • NEW YORK 19, N.Y. 

APPLICATION FOR APPOINTMENT 

NURSING SERVICE DEPARTMENT 



NAME (PRINT) 
ADDRESS 



BIRTHDAY 

WHERE REGISTERED 
POSITION SOUGHT 
DATE AVAILABLE 



MARITAL STATUS 



PROFESSIONAL BACKGROUND 



BASIC NURSING & 
POSTGRADUATE COURSES 


ADDRESS 


DATE OF DIPLOMA 
OR DEGREE 





















EXPERIENCE (LIST MOST RECENT POSITION FIRST) 




POSITION 


HOSPITAL AND LOCATION 


DATE 

































TRANSPORTATION FROM CANADA PAID UPON APPOINTMENT TO STAFF 
COAAMENTS: 



PLEASE INDICATE IN NUMERICAL ORDER, NURSING SERVICE PREFERRED: 
n MEDICINE □ MEDICINE & SURGERY Q PEDIATRICS 

□ SURGERY n OPERATING ROOM □ GYNECOLOGY 

SEND TO: DIRECTOR, NURSING SERVICE 
THE ROOSEVELT HOSPITAL 
428 WEST, 59th STREET 
NEW YORK 19, NEW YORK 




MARCH. 1959 • VOL. 55, No. 3 



279 



SCIENCE INSTRUCTOR 

& NURSING ARTS 

INSTRUCTOR 

REQUIRED 

FOR THE SCHOOL OF NURSING, 

QUEEN ELIZABETH HOSPITAL OF 

MONTREAL. PERSONNEL POLICIES 

AS RECOMMENDED BY THE 

A.N. P.O. 

For information, please write to fhe 

DIRECTOR OF NURSING, 

QUEEN ELIZABETH HOSPITAL 

OF MONTREAL, 

2100 MARLOWE AVE., 

MONTREAL, QUEBEC. 



VICTORIAN ORDER OF 
NURSES FOR CANADA... 

requires 

PUBLIC HEALTH NURSES 

for Staff and Supervisory positions in 
various parts of Canada. 

Applications will be considered from 
Registered Nurses without Public 
Health training but with University 
entrance qualifications. 

( 1 

I SALARY, STATUS AND PROMO- 

TIONS AKB DETERMINED IN 

RELATION TO THE QUALIFICA- ' 

' TIONS OF THE APPLICANT. I 



Apply to: 

Director in Chief, 

Victorian Order of Nurses 
for Canada 

5 BLACKBURN AVENUE 
Ottawa 2, Ont. 



EDUCATIONAL DIRECTOR 

FOR SCHOOL OF NURSING 

50-students, 1-closs a year. Good personnel poticies. Senary occording to 
qualifications. Present Director of Nursing was former Educational Director of 
School. Excellent relationships between hospital administrative staff & nursing 
school, Cornv/all "The Hub of the Seawoy" is an attractive, progressive city 
on international border easily accessible to Montreal & Ottawa. 

APPLY: 

DIRECTOR OF NURSING, GENERAL HOSPITAL, CORNWALL, ONTARIO 



TWO (2) REGISTERED NURSES 

For a new modern, 57-bed hospital. — Salary $255 - $285 per month. 

40-hour week, no split shifts, sick leave, 

3 weeks vacation plus 8 statutory holidays, full maintenance. 

Meals, living accommodation in new Nurses' Residence, 

and uniforms laundered for $34.50 per month. 

Apply: 

MRS. T. WALLACE, SUPERINTENDENT OF NURSES, KAMSACK UNION HOSPITAL, 

KAMSACK, SASKATCHEWAN. 



280 



THE CANADIAN NURSE 




GO NO 
FURTHER! 

YouHl find 
the experience 
at HOPKINS 



JOHNS HOPKINS offers 

• An exciting nursing career in a big and busy 
medical center. 

• Staff nurse positions in all clinical fields, with 
notable opportunities for advancement. 

• Liberal personnel policies, including Group Life 
Insurance and Retirement Income Plans. 




WRITE: 

DIRECTOR OF NURSING SERVICE 
THE JOHNS HOPKINS HOSPITAL 
BALTIMORE 5, MARYLAND 



MARCH. 1959 • VOL. 55. No. 3 



281 



OPERATING ROOM NURSE 

(EXPERIENCED) 

For new 85-bed General Hospital. Situated in a city of 
10,000 population with (2) R.C.A.F. Bases and has 
many recreational facilities. 

APPLY: THE ADMINISTRATOR, 
THE PORTAGE HOSPITAL, DISTRICT 18, PORTAGE LA PRAIRIE, MANITOBA 



THE PETERBOROUGH CIVIC HOSPITAL 

REQUIRES 

NURSES FOR GENERAL DUTY IN ALL SERVICES, INCLUDING 
OPERATING ROOMS & DELIVERY ROOMS. 

For further information write: 

THE DIRECTOR OF NURSING 

PETERBOROUGH CIVIC HOSPITAL, PETERBOROUGH, ONTARIO 



WOODSTOCK GENERAL HOSPITAL 

WOODSTOCK, ONTARIO 
REQUIRES INSTRUCTORS FOR 

1. SCIENCE 2. MEDICAL CLINICAL. 3. SURGICAL CLINICAL. 

4. TEACHING AND SUPERVISION OF CERTIFIED NURSING ASSISTANTS. 

HEAD NURSES — SURGICAL AND MEDICAL 3-1 1 P.M. 
GENERAL STAFF NURSES — EMERGENCY, OPERATING ROOM AND ALL 

DEPARTMENTS. 

GOOD PERSONNEL POLICIES — 5-DAY WEEK. 

For further information write: 

DIRECTOR OF NURSING, GENERAL HOSPITAL, WOODSTOCK, ONTARIO. 



CALIFORNIA 

REGISTERED NURSES 

(General Duty with opportunity for advancement) 

New modern 1 30-bed General Hospital in dynomk college dty in beautiful 

Son JcKiquin Valley only 2 hours from Los Angeles 

Salary: $325 to begin. Differential for evening & nights. 

5-day, 40-hr. wk. Progressive personnel policies. 

Transportation costs to California v/ill be reimbursed after 1-yr. satisfactory service. 

Send full parficulars immediately to: 

DIRECTOR OF NURSES, GREATER BAKERSFIELD MEMORIAL HOSPITAL 

P.O. BOX 26, BAKERSFIELD, CALIFORNIA 



282 THE CANADIAN NURSE 




NURSES WHO LIVE 

HERE NEVER STOP 

LEARNING . . . 

GROWING 

. . . THEY WORK AT 

COOK COUNTY 
HOSPITAL 

... in one of the Largest 

Most Stimulating Medical 

Centers in the World 



Residence, Cook County School of Nursing 

Here's an opportunity to gain unique and valuable experience in a public hospital — world's 
largest for acute medical conditions. Cook County Hospital offers you the stimulation of working 
with more than 2400 other doctors and nurses in one of the world's largest and most exciting 
medical centers. Housing is available at nominal cost. Salaries begin at $340-$372.50 for a 37'/i 
hour week. And you're only minutes from Chicago's fabulous Loop and local universities. 
Graduate Nurses! Write today to Director, Cook County School of Nursing, Dept. C, 1900 West 
Polk Street, Chicago 12, Illinois. 



SARNIA, ONTARIO 

CANADA'S CHEMICAL 
VALLEY 

AND 

PORTAL TO OUR BEAUTIFUL 

BLUEWATER COUNTRY 

You will enjoy being a port of this 
progressive, growing community 
OS an employee of the Sarnia 
General Hospital. 

Positions available in all 

services for 

REGISTERED NURSES 

Excellent Personnel Policies incbde 
40-hour week, 3 v/eeks paid annual 
vacation, 9 statutory holidays. 

Salary range $2,938 to 3,640 

Please apply to: 

PERSONNEL DIRECTOR 

SARNIA GENERAL HOSPITAL, 

SARNIA, ONTARIO 



THE WINNIPEG 
GENERAL 
HOSPITAL 

IS RECRUITING 

1. CLINICAL SUPERVISORS 
IN MEDICINE & SURGERY 

2. GENERAL DUTY NURSES 
FOR ALL SERVICES 

Please send applications direct to: 

THE DIRECTOR OF NURSING, 

THE WINNIPEG GENERAL 

HOSPITAL, 
WINNIPEG 3, MANITOBA. 



M..\RCH, 1959 • VOL. 35. No. 3 



283 



TORONTO GENERAL HOSPITAL 

requires 

NURSING STAFF 

Variety of Opportunities, Valuable Experience in this large teaching 
centre. Attractive Personnel Policies. The Toronto General Hospital has 
opened its new building which contains centralized Operating Rooms; 
Recovery Rooms; Surgical Supply Service; Obstetrics and Gynecology; 
Neurology and Neurosurgery; Admitting and Emergency; Rehabilitation and 
Physical Medicine; Urology and Ophthalmology. 

For informafion write fo. 

Director of Nursing, Toronto General Hospital, Toronto 2, Ontario. 



SARNIA, ONTARIO 

CERTIFIED NURSING 
ASSISTANTS 

As on employee of our modern 
well equipped hospital, you may 
enjoy the excellent opportunities 
offered as resident of this pro- 
gressive industrial city. 

Positions are available in all 
services. 

SALARY RANGE IS FROM 
$2,100 TO $2,508. 

Excellent employee benefits in- 
clude 40-hour, 5-day week. Shift 
differential for evening and night 
shifts. 9 statutory holidays. 

Please apply to: 

PERSONNEL DIRECTOR 

SARNIA GENERAL HOSPITAL, 

SARNIA, ONTARIO 



CHILDREN'S HOSPITAL 
OF WINNIPEG 

New 230-bed hospital 

with School of Nursing, 

approximately 

30 students a year, and affiliates, 

requires 

SCIENCE INSTRUCTOR AND 
CLINICAL INSTRUCTOR 

Either position may be combined 

with that of Educational Director, 

depending on qualifications. 

Also 

ASSISTANT NIGHT SUPERVISOR 

For details write: 
DIRECTOR OF NURSING 



284 



THE CANADIAN NURSE 



NURSING WITH INDIAN AND 

NORTHERN HEALTH SERVICES 




HOSPITALS 
NURSING STATIONS 
OTHER HEALTH CENTRES 



,%• \f 






OPPORTUNITIES 

REGISTERED HOSPITAL NURSES, PUBLIC HEALTH NURSES, 

AND CERTIFIED AUXILIARY NURSES 

for Hospital Positions and Public Health Positions in Outpost Nursing 
Stations, Health Centres and Field Positions in the Provinces, Eastern Arctic 
Northwest Territories and the Yukon Territory. 

SALARIES 

(1) Public Health Nursing Supervisors: up to $5,220 depending upon 
qualifications and location. 

(2) Directors of Nursing in Hospitals: up to $4,950 depending upon 
qualifications and location. 

(3) Public Health Staff Nurses: up to $3,780 per year depending upon 
qualifications and location. 

(4) Hospital Staff Nurses: up to $3,540 per year depending upon 
qualifications and location. 

(5) Certified Nursing Assistants or Licensed Practical Nurses: up to 
$200 per month depending upon qualiRcations and location. 

• Room, Board and Laundry in residence at reasonable rates. 
Statutory holidays. Three weeks' annual leave with pay. Generous sick 
leave credits. Hospital-Medical and superannuation plans available. 

• Special pay and leave allowances for those posted to isolated areas. 

For interesting, challenging, satisfying work apply to — Indian and 
Northern Health Services at one of the following addresses: 

(1) Regional Superintendent, 4824 Fraser Street, Vancouver, B.C. 

(2) Regional Superintendent, 1 141 2-1 28th Street, Edmonton, Alberta. 

(3) Regional Superintendent, 735 Motherwell Building, Regina, Saskatchewan. 

(4) Regional Superintendent, 803-9 Confederation Life Building, 457 Main Street, Winnipeg, 
Manitoba. 

(5) Regional Superintendent, 4th Floor, Booth Building, 165 Sparks Street, Ottawa, Ontario. 

(6) Zone Supervisor of Nursing, Box 493, North Bay, Ontario. 

(7) Zone Superintendent of Indian Health Services, P.O. Box 430, Upper Town, 3 Buade Street, 
Quebec 4, P.O. 

or 

Chief, Personnel Division, Department of National Health and Welfare, Ottawa, Ontario. 




MARCH, 1959 • VOL. 55. No. 3 



286 



Official Directory 
Provincial Associations of Registered Nurses 



ALBERTA 

Alberta Association of Registered Nurses 

Pres., Miss M. Street, Calgary Gen. Hosp., Cal 
gary; Past Pres., Miss E. Bietsch; Vice-Pres., Sr. 
C. Leclerc, Mrs. D. J. Taylor, Miss J. Clark. 
Committees: Nursing Service, Miss K. Alacalister; 
Nursing Education, Miss M. R. Thompson; Finance, 
Miss E. Bietsch; Legislation &■ By-Laws, Miss J. 
Clark. Exec. Director, Mrs. C. A. Van Dusen, 
10256-112th St., Edmonton. Registrar, Miss R. 
Schwindt. 10256-112th St., Edmonton. 

BRITISH COLUMBIA 

Registered Nurses' Association of British Columbia 

Pres., Miss E. Rossiter; Past Pres., Miss A. 
Creasor; Vice-Pres., Misses H. King, M. Frith; Hon. 
Sec., Miss E. Kunderman; Hon. Treas., Miss A. 
Cumming. Committees: Legislation, Constitution & 
By-Laws, Miss M. Campbell; Nursing Education, 
Miss M. Richmond; Nursing Service, Miss N. Wylie; 
Public Relations, Miss M. Macdonnell. Elxec. Sec. 
Miss Alice L. Wright, 2524 Cypress St., Vancouver 
9. Registrar, Miss F. McQuarrie. 

MANITOBA 

Manitoba Association of Registered Ntirses 

Pres., Mrs. H. C. Mazerall, 10 Wildwood Park, 
Winnipeg 9. Executive Secretary A Registrar, Miss 
L. E. Pettigrew, 247 Balmoral St., Winnipeg 1. 

NEW BRUNSWICK 

New Brunswick Association of Registered Nurses 

Pres., Miss L. O. Smith, Provincial Hospital, Lan- 
caster; Past Pres., Miss G. B. Stevens; Vice-Pres., 
Miss K. MacLaggan, Miss S. Miles; Hon. Sec, Sr. 
Theresa Carmel. Committees: Nursing Education, 
Miss D. Grieve, P.O. Drawer 1297, Fredericton; 
Nursing Service, Miss M. J. Anderson, Victoria 
Public Hosp., Fredericton; Advisory to Schools of 
Nursing, Miss M. Hunter, 670 Regent St., Frederic- 
ton; Finance, Miss K. MacLaggan, 385 Union Street, 
Fredericton; Legislation & By-Laivs, Miss S. Miles, 
Lancaster Hosp., Lancaster; Public Relations, Mrs. 
B. Norris, Box 55, Newcastle. Sec. -Registrar, Miss 
M. Archibald, 231 Saunders St., Fredericton. 



NEWFOUNDLAND 

Association of Registered Nurses 

Pres., Miss J. Story, 337 Southside Rd., St. John's; 
Past Pres., Miss E. Summers; Vice-Pres., Miss J. 
Lewis, Lt.-Col. H. Janes, Sr. M. Xaverius. Council- 
lors: Major M. Lydall, Misses G. Rowsell, R. Bishop, 
J. Collis, Rep. St. John's Chapter, N. Tilley, Rep. 
Corner Brook Chapter, Sr. M. Calasanctius, Rep. 
Nursing Sisterhood. Committees: Nursing Education, 
Miss G. Rowsell; Nursing Service, Miss H. Penny; 
Finance, Lt.-Col. H. Janes; Legislation &• By-Laws, 
Miss J. Lewis; Publicity & Public Relations, Miss I. 
Sutton; Rep. to: The Canadian Nurse, Miss I. 
Sutton. Exec. Sec, Miss Pauline Laracy, Cabot 
Bldg., Duckworth St., St. John's. 

NOVA SCOTIA 

Registered Nurses' Association of Nova Scotia 

Pres., Sr. C. Gerard; Past Pres., Mrs. D. Mc- 
Keown; Vice-Pres., Misses M. Matheson, J. Church, 
E. MacLennan; Rec. Sec, Miss D. Gill, Victoria 
Gen. Hosp., Halifax. Committees : Nursing Education, 
Miss F. Lytle; Nursing Service. Mr. W. Landry; 
Finance, Miss P. Lyttle; Legislation &■ By-Laws, Sr. 
M. Bernadette; Public Relations, Mrs. H. Mack; 
Discipline, Miss M. Graham; Credentials, Miss E. 
Purdy; Nominations, Miss H. Munroe; Board of 
Examiners, Sr. Clare Marie. Sec. -Registrar Miss 
Nancy H. Watson, 73 College St., Halifax. 



ONTARIO 

Registered Nurses' Association of Ontario 

Pres., Miss M. P. Morgan, Gen. Hosp., Hamilton; 
Vice-Pres., Miss E. M. Howard, Mrs. M. B. Dun- 
canson. Committees: Nursing Service, Miss E. M. 
Howard; Nursing Education, Miss H. G. Mc Arthur; 
Registration, Miss H. A. Bennett; Public Relations, 
Miss I. Black; Finance, Miss I. B. Brand; Legis- 
lation & By-Laws, Miss J. E. Young. District Presi- 
dents: Dist. 1, Miss L. W. Barr, 2111 Lincoln Rd., 
Windsor; 2, Miss P. C. Bluett, Gen. Hosp., Wood 
stock; 3, Mrs. M. Fligg, 985-7th Ave. E^ Owen 
Sound; 4, Mrs. O. G. Lewis, P.O. Box 154, FonthiU; 

5, Mrs. R. B. Couse, 582 O'Connor Drive, Toronto; 

6, Mrs. D. Stewart, R.R. 11, Peterborough; 7, Mrs. 
A. B. Rintoul, Maitland; 8, Miss D. F. Cowan, 5 
Ossington Ave., Ottawa; 9. Miss G. O'Leary, 204 
Oak St., Sudbury; 10, Mrs. B. Stewart, 76 Queen St., 
Box 362, Dryden; 11, Miss E. E. Langman, Royal 
Victoria Hosp., Barne; 12, Miss M. V. Kenney, 
x^nson Gen. Hosp., Iroquois Falls. Exec. Sec, Miss 
F. H. Walker, 33 Price St., Toronto S. 

PRINCE EDWARD ISLAND 

The Association of Nurses of Prince Edward Island 

Pres., Mrs. V. MacDonald, King's County Me- 
morial Hosp., Montague; Past Pres., Miss R. I. Ross; 
Vice-Pres., Misses B. Rowland, A. Trainor; Hon. 
Treas., Mrs. R. Palmer, P. H. Nurse, Health Centre, 
Summerside; Hon. Sec, Miss F. MacMillan, In- 
structor in Nursing, P.E.I. Hosp., Charlottetown. 
Committees: Nursing Education, Sr. M. Monica; 
Nursing Service, Miss I. MacKay; Public Relations, 
Miss H. MacLaine; Finance, Mrs. L. MacDonald; 
Legislation & By-Laws, Miss K. MacLennan. Exec. 
Sec-Registrar, Mrs. Helen L. Bolger, Igg Prince St., 
Charlottetown . 

QUEBEC 

The Association of Nurses of the Province of Quebec 

Pres., Miss M. Wheeler, 4442 Oxford Ave. Mont- 
real; Vice-Pres., (Fr.) Miles G. Lamarre, E. Mer- 
leau; (Eng.) Misses R. Chittick, E. Geiger; Hon. 
Sec, Mile G. C6t6; Hon. Treas., Miss G. Purcell. 
Councillors: Mile L. Lapointe (Dist. 1), Miss C. 
Aitkenhead (Dist. 3), Mile M. J. Clairmont (Dist. 
5), Mile G. Ducharme (Dist. 7), Mile F. Verret 
(Dist. 9). The above constitute the Executive Council 
and are members of the Committee of Management 
together with: Miles G. Gosselin, D. Pontbriand, S. 
Pilon, F. Bertrand, P. Levesque. M. J albert, L. 
Couet, Sr. Barcelo, Mile D. Fortin, Sr. M. Felicitas, 
Mile M. Desjardiils, Miss I. Jensen. Advisory Com- 
mittee: Mme. A. Martineau-Bergeron, Misses E. C. 
Flanagan, J. Golden, C. V. Barrett, H. Lamont, 
Mile R. Aubin, Mme Morency, Srs. Valerie de la 
Sagesse, St-Ferdinand, D. Lefebvre, Marie- Paule, St- 
Thomas d'Aquin. Committee Chairmen: Nursing Edu- 
cation, Sr. J. Forest, Miss M. Allen; Nursing Service. 
Mile G. Charbonneau, Miss M. MacKillop; Board 
of Examiners, (Eng.) Miss F. Bryant, (Fr.) Mile 
J. Trudel. Sec-Registrar & Visitor to English 
Schools of Nursing, Miss Helena F. Reimer. Visitor 
to French Schools of Nursing, Mile Suzanne Giroux. 
Association Headquarters, 640 Cathcart St., Mont- 
real. 

SASKATCHEWAN 

Saskatchewan Registered Nurses' Association 

Pres., Miss L. D. Willis, Ellis Hall, Univ. of 
Saskatchewan, Saskatoon; Vice-Pres., Miss L. Miner, 
4 Bartleman Apts., Regina: Sr. M. Hildegard, St. 
Elizabeth's Hosp., Humboldt. Committees: Nursing 
Education, Mrs. M. Rosso, Providence Hosp., 
Moose Jaw; Nursing Service, Miss K. Ruane, 
University Hosp., Saskatoon; Public Relations, Miss 
V. Spencer, 3 Canada Apts. Yorkton; Chapters, 
Miss B. Hailstone, 6 Garnet Apts., Regina. Exec 
Sec, Miss V. Antonini, 401 Northern Crown Bldg., 
Regina. Registrar, Miss Grace Motta, 401 Northern 
Crown Bldg., Regina. 



286 



THE CANADIAN NURSE 



Official Directory 

CANADIAN NURSES' ASSOCIATION 
270 Laurier Ave., W., Ottawa 

President Miss Alice Girard. Hopital St. Luc, Lagauciietire St.. Montreal, Que. 

Past President Miss Trenna G. Hunter, Metropolitan Health Com.. City Hall. Van- 
couver, B.C. 

First Vice-President Miss Helen Carpenter, 50 St. George St., Toronto 5, Ont. 

Second Vice-President .... Miss E. A. Electa MacLennan, School of Nursing, Dalhousie Univer- 
sity. Halifax, N.S. 

Third Vice-President Miss Hazel Keeler, University Hospital, Saskatoon, Sask. 

OenernI Secretary Miss M. Pearl Stiver. 270 Laurier Ave. W.. Ottawa. 

OTHER MEMBERS OF EXECUTIVE COMMITTEE 

Presidents of Provincial Associations — 

Alberta Miss Margaret Street, General Hospital, Calgary. 

Britisli Culnmhia Miss Edna Rossiter, Shaughnessy Hospital, Vancouver. 

Manitoba Mrs. Hilda Mazerall, 10 Wildwood Park, Winnipeg 9. 

New Itriinswick Miss Lois Smith, Provincial Hospital, Lancaster. 

Newfoundland Miss Janet Story, 337 Southside Rd., St. John's. 

Nova Scotia Rev. Sister C. Gerard, Halifax Infirmary, Halifax. 

Ontario Miss Margaret Morgan, Hamilton General Hospital, Hamilton. 

Prince Kdward Island .... Mrs. Vera MacDonald, King's County Memorial Hospital, Montague. 

Quebec Miss Margaret Wheeler, 4442 Oxford Ave., Montreal. 

Sasliatchrwaii Miss Lucy D. Willis. University of Saskatchewan. Medical Bldg.. 

Saskatoon. 

Religious Sisters (Regional Representation) — 

Maritimes Rev. Sister M. Irene, Charlottetown Hospital, Charlottetown. 

Quebec Rev. Sister M. Felicltas, St. Mary's Hospital, Montreal. 

Ontario Rev. Sister Madeleine of Jesus, Ottawa General Hospital, Ottawa. 

Western Canada Rev. Sister M. Laurentia. Providence Hospital, Moose Jaw. 

Chairmen of National Committees — 

Nursing Service Rev. Sister M. Felicltas, St. Mary's Hospital, Montreal. 

Nursing Education Miss Hazel Keeler, University Hospital, Saskatoon. 

Public Relations Miss Ethel M. Gordon, Apt. 110, 150 Argyle Ave., Ottawa 4. 

LeKisIatton and ny-I..awB . Miss E. A. Electa MacLennan, School of Nursing, Dalhousie Univer- 
sity, Halifax. 

Finance Miss Helen Carpenter, 50 St. George St., Toronto 5. 

Journal Itoard Mrs. Isobel MacLeod. Montreal General Hospital. Montreal. 

EXECUTIVE OFFICERS 

Alberta Ass'n of Uegistered Nurses, Mrs. Clara Van Dusen, 10256 - 112th St.. Edmonton. 

Registered Nurses' Ass'n of British Colnmbia, Miss Alice L. Wright. 2524 Cypress St., Van- 
couver 9. 

Manitoba Ass'n of Registered Nurses, Miss Lillian E. Pettigrew, 247 Balmoral St., Winnipeg. 

New Itruuswick Ass'n of Registered Nurses, Miss Muriel Archibald, 231 Saunders St., Fredericton. 

Ass'n of Registered Nurses of Newfoundland, Miss Pauline Laracy, Cabot Bldg., Duckworth St., 
SI. John's. 

Registered Nurses' Ass'n of Nova Scotia, Miss Nancy H. Watson, 73 College St., Halifax. 

Registered Nurses' Ass'n of Ontario, Miss Florence H. Walker, 33 Price St., Toronto 5. 

Ass'n of Nurses of Prince Edward Island, Mrs. Helen L. Bolger, 188 Prince St., Charlottetown. 

Association of Nurses of the Province of Quebec, Miss Helena Reimer, 640 Cathcart, St., Montreal. 

Saskatchewan Registered Nurses' Ass'n. Miss Victoria Antonlni. 401 Northern Crown Bldg.. 
Regina. 

ASSOCIATION OFFICERS 

Canadian Nurses' Association: 270 Laurier Ave. West. Ottawa. General Secretary-Treasurer. Miss 
M. Pearl Stiver. Secretary of Nursing Service. Miss F. Lillian Campion. Assistant General Secretary, 
Miss Rita Maclsaac. 

International Council of Nurses: 1 Dean Trench St.. Westminster, London S.W. 1. England. 
General Secretary, Mlss Daisy C. Bridges. 

MARCH. 1959 • VOL. 55, No. 3 287 



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7S^S»u^ ^^^ut^ f^aH€<4^ ^yH^ 



APRIL. 1959 • VOL. 55. No. 4 



289 



INDEX TO ADVERTISERS 



APRIL, 1959 



Abbott Laboratories Ltd 361 

Becton, Dickinson & Co. 

(Canada) Ltd 349 

Bland & Co 301 

Bristol-Myers Co. of Canada Ltd. 293 

Canadian Banana Co. Ltd 345 

Canadian Industries Ltd 347 

Canadian Tampax Corp. Ltd. . . . 365 

Carnation Co. Ltd 302 

J & J Cash (Canada) 298 

Cow & Gate (Canada) Ltd 355 

Desitin Chemical Co Cover III 

Charles E. Frosst & Co 339 

G. T. Fulford Co. Ltd 367 

Geigy Pharmaceuticals (Canada) 
Ltd 331 

The Good-Lite Mfg. Co 366 



John A. Huston Co. Ltd 333 

Imperial Tobacco Co. 

of Canada Ltd 369 

Knox (jrelatine (Canada) 
Ltd 340,341,342,343 

The Kendall Co. (Canada) Ltd. . 353 

I. B. Lippincott Co Cover IV 

S. E. Massengill Co 368 

Nivea Pharmaceuticals Ltd 337 

Ortho Pharmaceuticals 

(Canada) Ltd 359 

Parke Davis & Co. Ltd 357 

Reitman's Inc 335 

W. B. Saunders Co 351 

Smith Kline & French 363 

Smith & Nephew 392 

Swift Canadian Co. Ltd 289 

\\^hite Sister Uniform Inc. . . Cover II 



Subscription Rates: Canada & Bermuda: 6 months $1.75; one year, $3.00; two years. $5.00. 
Student nurses — one year, $2.00 ; three years, $5.00. 
U.S.A. & foreign : one year, $3.50 ; two years, $6.00. 
Single copies 35 cent*. 

In combination with the American Journal of Nursing or Nursing Outlook: one year. $8.00 
Make cheques and money orders payable to The Canadian Nurse. 

Change of address: Four weeks' notice and the old address as well as the new are necessary. 

Not responsible for Journals lost in mail due to errors in address. 

Authorized as Second-Class Mail, Post OflFice Department, Ottawa. 

Member of Canadian Circulation Audit Board. 

Advertising Representatives: W. F. L. Edwards & Co., Ltd., 34 King St. E., Toronto 1, Ont. 
Walter Slack, 801 Public Ledger Building, Philadelphia 6, Pa. 

1522 Sherbrooke Street West, Montreal 25, Quebec 



290 



THE CANADIAN NURSE 



THE CANADIAN NURSE 



VOLUME 55 



NUMBER 4 



APRIL 1959 



292 Between Ourselves 

294 New Products 

303 The Dignity of Service 

305 Cardiac Arrest L. F. G. Cruickshatik 

307 Congenital Heart Surgery A. T. Mildenberger 

31 O BrrrpI Brrrp! M. Stockley 

312 A New Medication Setup P. Morley 

314 LTnfirmiere Educatrice et 

Conseillere Y. Nolebaert 

31 8 The Nature of Research M. Uprichard 

321 Better Utilization of the Students' 

Time in the Clinical Field Sr. M. Felicitas 

326 Nursing Profiles 

327 In Memoriam 

329 The CNA Retirement Plan 

Becomes a Reality iV. R. Beaudin 

332 The Adviser to Schools 

of Nursing A/. E. Schumacher 

338 Nursing Across the Nation 

341 Le Nursing a travers le pays 

344 The Male Potential R. S. Bentley 

348 A New Treatment for Brittle Nails C. Halliday 

3BO A New Orthopedic Brace M'. R. Graydon 

362 Provincial Roundup 

366 The Nurses" Life /. Munro 

368 Book Reviews 

362 Macmillan Award Winners 

362 News Notes 

370 Official Directory 

372 Employment Opporiunities 



The views expressed 
in the various articles 
are the I'icivs of 
the authors and 
do not necessarily 
represent the policy 
or viezvs of 

The Canadian Nurse 
nor of the Canadian 
Nurses' Association. 



Journal Boord: Mrs. A. I MacLeod, chainnaii. Si . M. Fel.citas, Misses H. Camentec, K. Chittick, S. Giroux, 
fc. (jordon, K. MacLaggan, A. fiirard, president CNA; Misses M. P. Stiver, M. E. Kerr. 

edilorial AcfWsers: Alberta, Miss Irene M. Robertson, 11831-87th Ave., Edmonton; Briti.h Columbia. Miss 
Marion t. Macdonnell, 1807 \V 36th Ave., Vancouver 13; Manitoba, Miss Sheila L. Nixon, 
Children s Hospital. Winnipeg; New Brunswick, Miss Shirlev Y. Alcoe, 180 Charlotte St, 
1-redericton ; Newfoundland, Miss Isabel Sutton, 66a Mullock' St., St. John's; Nova Scotia, 
Mrs. Hope Mack, ['.O. Box 76, Hantsport; OnUrio, Miss Tean Watt, RiN A O 33 Price St 
loronto; Prince Edward Island. Sr. M. David, Charlottetown Hospital; Quebec, Miss Genevieve 
Lamarre, Hopital de 1 Enfant Jesus, Quebec City (French), Sr. M. Assumpta. St. Mary's Hospital, 
Montreal (English) ; Saskatchewan, Miss Victoria Antonini, S.R.X.A., 401 Northern Crown iVldg 



Regina. 

, . Executive Director: Margaret E. Kerr, M.A., R.X. 

Assistant Editors : Jean E. MacGregor. B.N., R.N.; Gabrielle D. Cote, M.A.. R.N. 
Lirculatwn Manager: W innifred MacLean. Production Assistant: Elizabeth M. Hanlon. 
Advertising Assistant: Ruth H. Baumel. 

1522 Sherbrooke Street West, Montreal 25, Quebec 



APRIL. 1959 • VOL. 55, No. 4 



^et€<^^£H Ouft^€i^/i€4> 



Just as we liave invited you to share our 
joy over each new section of the Journal as 
it has been added, so now we realize that 
with the news we bring today there will be 
for many of you a distinct feeling of regret, 
as at the passing of an old friend. Ever 
since The Canadian Nurse was first publish- 
ed fifty-four years ago, news columns telling 
of local activities have been included. Next 
month they are appearing for the last time. 

Several considerations influenced the Ex- 
ecutive Committee of the Canadian Nurses' 
Association, at its recent meeting, to vote 
that this section should be discontinued. The 
principle reason was the fact that this is the 
only editorial part of the magazine that 
would be different when our twin issues 
commence in June. 

Unlike 1905, when there were no provin- 
cial nurses' associations as we know them 
today, we not only have ten very active 
bodies but many of them have bulletins that 
are sent out at regular intervals to their 
membership. It was felt by the Executive 
that that was the logical organ to carry the 
accounts of chapter meetings. The roster of 
alumnae associations from which items of in- 
terest have been received regularly has been 
dwindling very considerably. Another item 
that has also been discontinued is the publi- 
cation of the lists of appointees to various 
jniblic health nursing organizations. 
* * * 

Speaking of the recent Executive Com- 
mittee meeting, brief reports of some of the 
national committee activities will be found in 
"Nursing across the Nation." The survey of 
Journal readership revealed that only about 
a quarter of the nurses of Canada read the 
items that are published under that caption. 
Since it is the primary source of information 
regarding the many aspects of the work be- 
ing carried on nationally in our name, it 
should be one of the best-read sections. How 
else can you know what is going on? 

Several hours, at the meetings, were de- 
voted to the discussion of the provincial 
executive secretaries' reports. We wish that 
it were possible to share these reports 
with you in full. They reflect an intense 
interest in a wide varietv of new and vital 



developments. Since space does not permit 
their reproduction in full Provincial Bound- 
up points to the principal avenues along 
w^iich the provincial associations are moving. 

* * * 

One of the speakers at the Editorial Ad- 
visers' conference in January was a promi- 
nent Montreal newspaperman. His comment 
regarding the titles of the articles in an 
average issue was that they did not have 
enough sparkle, not enough spice in them. 
He proposed that we should experiment now 
and then to learn your reaction. 

When we were preparing Miss Stockley's 
account of the instruction she gives post- 
laryngectomy patients, we decided to act 
on the newspaperman's suggestion. Honestly, 
are you more intrigued by the title we have 
used or would you have been just as inter- 
ested to read had we used the sub-heading 

as the main caption ? 

* * * 

The sudden failure of the heart in any 
patient is an agonizing experience for the 
nurse who is immediately responsible for his 
care. Inevitably, there is the feeling that 
perhaps life could have been saved if only 
someone who knew what to do had reached 
him soon enough. More often than the aver- 
age person is willing to believe, there is, un- 
fortunately, nothing that could have been 
done if some serious heart disease is present. 

Cardiac arrest during surgery is even 
more terrifying to the nurse. It is usually 
caused by a lack of oxygen in the vital tis- 
sues. There are various predisposing factors 
that may contribute to this anoxia on the 
operating table : insufficient preoperative 
dosage of atropine ; overdosage of a preanes- 
thetic drug ; decreased vital capacity ; ane- 
mia, anxiety, shock ; pvilmonary or heart dis- 
ease. 

Whatever the cause, the response must be 
immediate and efi^ective, not only to restore 
the heartbeat but also to reestablish the 
oxygen system before irreversible damage 
has been done to the brain. Time is the 
driving factor. Dr. Cruickshank gives three 
minutes as the limit of safety. So each nurse 
member of the operating staff must know by 
heart what is and what is not to be done. 



Virtue consists in not desiring vice. 



292 



THE CANADIAN NURSE 



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The effectiveness of New Stainless Pazo 
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New Stainless Pazo Ointment and 
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APRIL, 1959 • VOL. 55, No. 4 



293 



Edited by DEAN F. N. HUGHES 

Published Through Courtesy of Canadian Pharmaceutical Journal 

CENTRINE 

Indications — Peptic ulcer, pylorospasm, hypertrophic gastritis, vomiting of pregnancy. 

Administration — Tablets: 0.5 mg. (1 tablet) 3 or 4 times daily. 

Solution: initially 2 to 5 drops before meals and at bedtime increasing by one or 
more drops depending on response. For infants use dosage schedules as for atropine. 

Injection: 1 cc. (0.5 mg.) repeated if necessary in 3 or 4 hours. 

Description — Aminopentamide (alpha, alpha - diphenyl - gamma-dimethylaminovaler- 
amide), parasympatholytic antispasmodic. 

Manufacturer — Bristol Laboratories of Canada Limited, Montreal. 

CETOGEN 

Indications — The treatment of headache, neuralgia, colds, in children. 
Administration — One tablet with a little water 2 or 3 times a day as prescribed. 
Description — Each tablet contains; Cetogen Vs gr. phenacetin Vs gr. and caffeine 
citrate Vs gr. 

Cetogen with Codeine: Cetogen with codeine 1/30 gr. per tablet. 

CIDALON 
Indications — The eradication of scabies, head lice, crab lice, ticks. 
Administration — Apply as directed. 

Description — An emulsion containing isobornylthiocyano-acetate 4% 
Manufacturer — Canadian Pharmacol Co. Ltd., London. 

CHOLEDYL 

Indications — Whenever the cardiovascular, diuretic, and bronchodilator effects of 
theophylline (or its double salt, aminophylline) are indicated: edema, angina, asthma and 
premenstrual tension. 

Administration — Adults: Initiate with 200 mg. q.i.d.; adjust dosage to individual re- 
quirements. Children: 100 mg. t.i.d. or q.i.d. 

Description — Choline theophyllinate. 

Manufacturer — Warner-Chilcott Laboratories Co. Ltd., Toronto. 

CORTATE 
Indications — Addison's disease asthenia associated with adrenal cortical deficiency, 
radiation sickness. 

Administration — 2 to 6 mg. as prescribed. 

Description — Preparation of desoxycorticosterone acetate. 

Manufacturer — Schering Corporation Limited, Montreal 9. 

CO-SALT 

Indications — As a salt substitute in conditions requiring low salt diets, e.g., congestive 
heart failure, hypertension. 

Description — Salt substitute containing; Choline, potassium chloride, ammonium 
chloride, tricalcium phosphate. Contains no sodium or lithium: 

Manufacturer — U.S. Vitamin Corporation of Canada Limited, Montreal. 

DULSANA COMPOUND 

Indications — For the symptomatic relief of cough in pharyngitis, laryngitis, tracheitis 
bronchitis, pneumonia, bronchiectasis bronchial asthma, whooping cough, smoker's cough 
and the "cough habit of nervous origin." 

Administration — Adults: One or two teaspoonfuls (5-10 cc.) 3 or 4 times daily, as 
required. Children: 6-12 years: one-half to one teaspoonful (2.5-5 cc.) 3 or 4 times daily, 
as required: children under 6 years as recommended by the physician. 

Description — Each 5 cc. teaspoonful contains: Paracarbinoxamine maleate 2 mg., 
ephedrine hydrochloride 4 mg., codeine phosphate 10 mg., ammonium chloride 100 mg., 
chloroform 25 mg., menthol 0.25 mg., flavored syrup base q.s. 

Manufacturer — Charles E. Frosst & Co., Montreal. 

SAL-INFANT Suppositories 

Indications — For analgesia and antipyretic effect in children when an alternative to 
oral administration is desired. 

Administration — Children under 5 years: V2 to one ounce or twice daily according to 
body weight. Five years and over: one suppository one to 3 times daily. 

Description — Each suppository contains: Acetylsalicylic acid 15(] mg. in a hydrophilic 
base. 

Manufacturer — Mowatt & Moore Ltd., Montreal. 

The Journal presents pharmaceuticals for information. Nurses understand that only a physician may prescribe. 
294 THE CANADIAN NURSE 



UNIVERSITY OF BRITISH COLUMBIA 

COURSES FOR GRADUATE NURSES 

1. Leading to the Degree of Bachelor of Sc/ence in Nursing IB.S.N.): 

An integrated program which includes preparation for staff positions in 
public health nursing as well as the fundamentals of teaching, supervision 
and administration and their application to clinical nursing. Students are 
required to select one advanced clinical nursing course — i.e., Medical- 
Surgical, Obstetric, Pediatric, or Psychiatric Nursing. 

Students with an appropriate Senior Matriculation can complete the 
Course in approximately two years. Those with Junior Matriculation re- 
quire approximately three years. 

2. Leading to a Diploma in Publii: Health Nursing: 

A ten-month course which prepares for staff positions in public health 
nursing. 

3. Leading to a Diploma in Clinical Teaching and Supervision: 

A ten-month course which prepares for hospital positions that entail 
teaching, supervisory and administrative activities. Students are required 
to select one of the advanced clinical nursing courses listed above. 

N.B.: The School of Nursing also offers, for high school graduates with University Entronce, a 
Basic Professional Course leading to the degree of B.S.N. 

For further information write to the 

DIRECTOR, SCHOOL OF NURSING, UNIVERSITY OF BRITISH COLUMBIA, 
VANCOUVER 8, BRITISH COLUMBIA. 



FLORINEF TABLETS 

Indications — For the treatment of Addison's disease and adrenocortical hyperplasia ol 
the adrenogenital type. 

Administration — Addison's disease — A daily oral dosage range of 0.1 to 0.3 mg., has 
produced satisfactory salt retention. Supplementary parenteral administration of sodium- 
retaining hormones is not necessary. Adrenocortical hyperplasia of the adrenogenital type 
— Satisfactory inhibition of endogenous adrenocortical hypersecretion has been achieved 
with daily doses of 1.0 to 2.0 mg. This dosage range has been found to reduce and maintain 
the 17-ketosteroid excretion at or near normal levels. 

Description — Fludrocortisone acetate for oral use, tablets 0.1 mg. 
Manufacturer — E. R. Squibb & Sons of Canada Ltd., Montreal. 

METASPAS TABLETS 

Indications — Wide spectrum synthetic antispasmodic agent in: functional diarrhea, 
dysmenorrhea, pre-and intermenstrual syndromes, false labor and during actual labor, 
post-partum; spasmodic cough, vomiting, nausea, motion sickness, drug intolerance, sur- 
gical premedication, exploratory instrumental procedures. 

Administration — Adults: 3 to 9 tablets daily in divided doses of 1 to 3 tablets. 

Children: V2 to 2 tablets daily in the same manner. 

Infants: (under 1 year): 1/4 to V2 tablet daily according to age. The daily dose diluted 
in a small quantity of water in the morning could be divided for several administrations 
during the day. 

Contraindications — Like most atropine-like products, is contraindicated in glaucoma. 

Description — Each tablet contains 10 mg. of beta (N-piperidine)-ethyl-cyclohexyl-l, 
cyclohexane carboxylate hydrochloride, dihexyverine hydrochloride). 

Manufacturer — Thomas Leem ing & Co. Inc., Montreal. 

PROMANYL ~ 

Indications — As an ataractic in: alcoholism, acute hallucinosis and disturbed 
psychotics, drug addiction. 

Administration — In doses as prescribed and in accordance with patient's condition 
and response. Total daily dose should not exceed 1 Gm. 

Description — Promazine HCl tablets, 25 mg., 50 mg., 100 mg. 

Manufacturer — Paul Money Laboratories Canada Ltd., Toronto 14. 

APRIL. 1959 • VOL. 55. No. 4 295 



McMASTER UNIVERSITY 
School of Nursing 

I DEGREE COURSE IN BASIC NURSING (B.Sc.N.) 

A Four-Year Course designed to prepare students for all branches of 
community and hospital nursing practice and leading to the degree, 
Bachelor of Science in Nursing (B.Sc.N.). It includes studies in the human- 
ities, basic sciences and nursing. Bursaries, loans and scholarships are 
available. 

II DEGREE COURSE IN SCIENCE TEACHING 
FOR GRADUATE NURSES (B.Ed.N) 

A Two-Yeor Course designed to prepare graduate nurses to teach basic 
sciences in schools of nursing and leading to the degree, Bachelor of 
Education in Nursing (B.Ed.N.) It includes studies in the humanities, the 
physical, social and biological sciences, teaching and nursing education. 
Bursaries of Six Hundred Dollars each are offered m botfi years of this 
Course. 

For additional information, write to: 

School of Nursing, 
McMaster University, Hamilton, Ontario. 



MONTREAL 

NEUROLOGICAL 

INSTITUTE 

McGILL UNIVERSITY 

GRADUATE COURSE 

in 

NEUROLOGICAL AND 

NEUROSURGICAL NURSING 

AND OPERATING ROOM 

TECHNIQUE 

Classes: Feb. 1 & Oct. 1 

One half staff salary is paid during 
course. Students may live in or out. 

For information apply: 

MISS E. C. FLANAGAN, B.A., R.N. 

Director of Nursing, 

3801 University St. 

Montreal, Que. 



THE MOUNTAIN 
SANATORIUM 

HAMILTON, ONTARIO 

TWO-MONTH 

POSTGRADUATE COURSE 

IN THE IMMUNOLOGY, 

PREVENTION & TREATMENT 

OF TUBERCULOSIS 

This course is especially valuable 
to those contemplating Public 
Health, Industrial, or Tuberculo- 
sis Nursing. 

For further injorviation apply to: 

Director of Nursing, 

Mountain Sanatorium 

Hamilton, Ontario. 



296 



THE CANADIAN NURSE 



DALHOUSIE UNIVERSITY 

School of Nursing 

COURSES OFFERED 

1959-1960 

1. Degree Course in Basic Professional Nursing 

Candidates for the degree of Bachelor of Nursing are required to complete 
2 years of university work before entering the clinical field, and one year 
of university work following the basic clinical period of 30 months. On 
completion of the course the student receives the Degree of Bachelor of 
Nursing and the Professional Diploma in either Teaching in Schools of 
Nursing or Public Health Nursing. 

2. Degree Course for Graduate Nurses 

Graduate nurses who wish to obtain the degree of Bachelor of Nursing 
ore required to complete the three years of university work. 

3. Diploma Courses for Graduate Nurses 

(a) Public Health Nursing 

(b) Teaching in Schools of Nursing 

For further information apply to.- 

DIRECTOR, SCHOOL OF NURSING 
DALHOUSIE UNIVERSITY, HALIFAX, N.S. 



PSYCHIATRIC COURSE 

for 

REGISTERED NURSES 

The Nova Scotia Hospital offers to 
qualified Registered Nurses a six- 
month certificate course in Psychiatric 
Nursing. 

• Classes in March and September. 

• Remuneration. 

• Preference given to Nova Scotia 
applicants. 

For further information apply to : 

Superintendent of Nurses 
Nova Scotia Hospital 
Drawer 350 
Dartmouth, Nova Scotia 



NOVA SCOTIA SANATORIUM 

KENTVILLE N.S. 

Offers to Graduate Nurses a Six- 
Month Course in Tuberculosis Nursing, 
including Immunology, Prevention, 
Medical & Surgical Treatment. 

1. Full series of lectures by Medical 
and Surgical staff. 

2. Demonstrations and Clinics. 

3. Experience in Thoracic Operating 
Room and Postoperative Unit. 

4. Full maintenance, salary & all staff 
privileges. 

5. Classes start May 1st and Novem- 
ber 1st. 

For information apply to : 

SUPT. OF NURSES, NOVA SCOTIA 
SANATORIUM, KENTVILLE, N.S. 



APRIL, 1959 • VOL. 55. No. 4 



297 



THE WINNIPEG GENERAL 
HOSPITAL 

Offers to qualified Registered Grad- 
uate Nurses the following opportunities 
for advanced ])reparation : 

1. A six month Clinical Course in 
Obstetrics. 

2. A six month Clinical Course in 
Operating Room Principles and 
Advanced Practice. 

These courses commence in January 
and September of each year. Main- 
tenance is provided. A reasonable sti- 
pend is given after the first month. 
Enrolment is limited to a maximum of 
six students in each course. 

For further iuforiiuition please 
■ii.<rite to: 

DIRECTOR OF NURSING 

GENERAL HOSPITAL 
WINNIPEG, MANITOBA 



THE NATIONAL HOSPITAL 

QUEEN SQUARE 

London, W.C.I 

and 

MAIDA VALE HOSPITAL 

London W.9, England 

(Institute of Neurology, University of 
London) 

Postgraduate Nursing Education for 

Medical Neurology & Brain Surgery 

One year courses are open to Nurses on 

the General Register with good educational 

bockground. 

3 mo. full time instruction in the school 
under guidance of the Sister Tutor assisted 
by a teaching staff of senior neurologists 
& neuro-surgeons. 

8-mo. clinical experience, 1 mo. vacation. 

Certificate & badge of the hospital awarded 
to successful students. Staff nurses' salary 
paid throughout the year. This work has a 
special appeal to nurses interested in 
research & the humanitarian aspect of 
nursing. 

For further partitulars apply to the Matron, 

THE NATIONAL HOSPITAL 



CHILDREN'S HOSPITAL 
OF WASHINGTON, D.C. 

OFFERS 

Registered Nurses a 16-wk. supple- 
mentary program in pediatric nursing. 
Admission dates. May 6, September 1, 
1959, January 5, May 3, August 30, 
1960. 

For complete information write fo; 

DIRECTOR OF NURSING, 
21 25-1 3th STREET, N.W., WASHINGTON 9, D.C. 



> EFfic /ency 
^k Econamy 
M Protection 




THAT ALL UNIFORMS 
CLOTHING AND 
OTHER BELONGINGS 
ARE MARKED WITH 



CASH'S NAMES 

Permanent, easy identification. Easily sewn on or 

attoched with No-So Cement. From dealers or 

CASH'S Belleville 5, Ont. 

CASH'S: 3 Doz. $1.80; 9 Doz. $3.00; NO-SO 
NAMES: 6 Doz. $2.40; 12 Doz. $3.50; 3S<: per tube 



THE JOHNS HOPKINS 
HOSPITAL 

SCHOOl of NURSim 



Offers to qualified Registered Nurses 
a 16- week supplementary course in 

OPERATIVE ASEPTIC TECHNIC 

with instruction and practice in the 
general surgical, neurosurgical, plastic 
orthopedic, gynecologic, ophthalmolo- 
gic, urologic and ear, nose and throat 
operating room services. Maintenance 
and stipend are provided. 

For iiiforniatioii ivrite to: 

DIRECTOR, SCHOOL OF NURSING 

THE JOHNS HOPKINS HOSPITAL 

BALTIMORE 5, MARYLAND, U.S.A. 



298 



THE CANADIAN NURSE 



UNIVERSITY OF SASKATCHEWAN 
School of Nursing 




in cooperation with 
UNIVERSITY HOSPITAL 



PROGRAMS FOR GRADUATE NURSES 

Teaching and Supervision 

To meet the needs of nurses wishing to prepare for positions of responsi- 
bility in either teaching or supervision in Schools of Nursing. 

Public Health Nursing 

To meet the needs of nurses wishing university preparation for staff uork 
in public health nursing agencies. 

Administration of Hospital Nursing Service 

To meet the needs of nurses preparing for head nurse, supervisory or 

matron positions. 

This program is supported by the W. K. Kellogg Foundation. 

Diplomas are granted on successful completion of the above programs and 
credits earned may be applied toward the degree of Bachelor of Science in 
Nursing. 

PROGRAMS FOR HIGH SCHOOL GRADUATES 

Leading to the Degree in Nursing 

Students with senior matriculation may pursue a combined academic 
and professional program leading to the degree of Bachelor of Science in 
Nursing. In the final year students will elect to study Teaching and 
Supervision or Public Health Nursing. This broad educational background 
followed by graduate professional experience enables nurses to progress 
rapidly into positions of responsibility. 

Leading to the Diploma in Nursing 

A three year hospital program is conducted for students meeting the 
entrance requirements of the University. 

For further infonnatiun or inquiries ulyout scholarship's, i^'rilc to: 

DIRECTOR, SCHOOL OF NURSING, UNIVERSITY OF SASKATCHEWAN, 

SASKATOON, SASKATCHEWAN 



.APRIL. 1959 • VOL. 55. No. 4 



rfie New York Polyclinic 

MEDICAL SCHOOL AND HOSPITAL • Organized 1 881 

The Pioneer Postgraduate Medical Institution in America 

Announces the following Courses (Six Months Duration) 
for qualified Graduate Nurses 

OPERATING ROOM NURSING 

MEDICAL SURGICAL NURSING 

OUT PATIENT DEPARTMENT NURSING 

Courses include lectures by the Faculty of the Medical School and the 
Nursing Department 

Stipend of $50.00 per month and full rnaintenance is provided 

For information address: 
Director of Nursing Education, 345 W. 50th St., New York, 19, N.Y. 



WILLS EYE HOSPITAL 
Philadelphia, Penna. 

The largest eye hospital in the 
United States, offers a six-month 
course in Nursing Care of the Eye to 
Graduates of Accredited Nursing 
Schools. Operating Room Training is 
scheduled in the course. 

• $205 per month for the first four 
months. $215 per month for the last 
two months. 

• REGISTRATION FEE is $20 

• Course starts March 15 & Septem- 
ber 15. Ophthalmic Nurses in great 
demand for hospital eye departments, 
operating rooms & ophthalmologists' 
offices. 



For iiifiiniiatioii i^'ritc to: 

Director of Nurses, 

Wills Eye Hospital, 

1601 Spring Garden Street, 

Philadelphia 30, Penna. 



COURSES 

FOR 

GRADUATE NURSES 

In various clinical fields, 
beginning June 1, August 2A, 
November 16, 1959, and 
February 8, 1960. 

Room, meals, laundering of 
uniforms, and honorarium 
provided. 

Apply to: 

DIRECTOR, 

COOK COUNTY SCHOOL 

OF NURSING, 

DEPT. C, 1900 WEST POLK ST., 

CHICAGO 12, ILLINOIS 



300 



THE CANADIAN NURSE 



ROYAL 
VICTORIA 
HOSPITAL 

SCHOOL OF NURSING 

MONTREAL, QUEBEC 

Postgraduate Courses 

1. (a) Six month clinical course in Obstet- 
rical Nursing. 
Classes — September and February. 

(b) Two month clinical course in Gyneco- 
logical Nursing. 

Classes following the six month 
course in Obstetrical Nursing. 

(c) Eight week course in Care of the 
Premature Infant. 



2. Six month course in Operating Room 
Technique and Management. 
Classes — September and March. 



3. Six month course in Theory and Practice 
in Psychiatric Nursing. 
Classes — September and March. 



Complete maintenance or living-out allow- 
ance is provided for the full course. 

Salary — a generous allowance for the 
last hallf of the course. 

Graduate nurses must be registered and in 
good standing in their own Provinces. 

For information and details of the courses, 
apply to: — 

Miss H. M. Lamont, B.N. 

Director of Nursing, 

Royal Victoria Hospital, 

Montreal, P.O. 



DON'T COUNT IT 

AN EXTRAVAGANCE WHEN YOU 

BUY THE BEST. 

THE SATISFACTION YOU WILL 

ENJOY WILL MORE THAN 

REPAY YOU. 




GOOD UNIFORMS ARE 

MADE AND SOLD BY 

BLAND & CO. 

2048 Union Ave., Montreal, Con. 



APRIL. 1959 • VOL, 55. No. 4 



301 




Why Carnation Merits 
Your Recommendation 

No other form of cow's milk supplies more complete 
nourishment for infant feeding. A Carnation Evaporated 
Milk formula provides: 

• All the food values of pasteurized whole milk, in a more 
digestible form. 

• All the butterfat of whole milk, so important for normal energy. 

• Increased Vitamin D — 800 units per pint of Carnation. 

• Known bacteriological safety. 



Safeguards of uniformity. 



Carnation protects your 
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tarnation 



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302 



THE CANADIA.N .NURSK 



THE CflOflDlflO mm 

A MONTHLY JOURNAL FOR THE NURSES OF CANADA 
PUBLISHED BY THE CANADIAN NURSES' ASSOCIATION 



VOLUME 55 



NUMBER 4 



MONTREAL, APRIL 1959 



The Dignity of Service 



WE ARE NOW APPROACHING the scason 
of the year when a great many of 
the schools of nursing across Canada 
will be holding their formal graduation 
exercises. Hundreds of social affairs 
— parties, receptions, dances — will 
be held to help the new graduates 
celebrate the successful conclusion of 
three years of very active learning 
experiences. Countless gifts from well- 
wishers will mark the occasion. Prizes 
will be awarded ; farewells will be said : 
then the schools will settle down to 
another year of relative calm. 

At most of the graduation exer- 
cises, some outstanding representative 
of the community, some well-loved 
member of the hospital staff, or per- 
haps some leader among the nursing 
profession will be invited to deliver 
an address to the graduating class. 
Periodically, these guest speakers are 
perplexed as to what ground they 
should cover, what theme they should 
develop. This seems an appropriate 
time, therefore, to crystallize a few 
of the highlights of nursing philosophy 
into a form that may be helpful to 
the speakers. Going further, it is our 
hope that this brief summary may 



prove a stimulus not only to the new 
graduates but also to the thousands 
who have graduated before them. 

The one word that seems to sum 
up most adequately the whole philoso- 
phy of nursing is "service." If ques- 
tioned, most nurses would reply that 
they entered their school in the first 
place because they wanted "to help 
people who w^ere ill." From their 
earliest days as preclinical students 
until their last interview with their 
director of nursing, the principal accent 
has been on service — to their pa- 
tients, their families, the community. 
Every form the service may take — 
be it as simple as a sip of water to a 
thirsty patient, or as complex as the 
preparation of an operating theatre 
for surgery — carries with it a dignity 
that belies such terms as menial, drud- 
gery. Service may be tiring. Some- 
times it is trying. But always, thought- 
ful service to others is rewarding. 

Directors of nursing are very con- 
scious of the importance of the relation- 
ship between the service provided by 
their staff" and the students, and pub- 
lic esteem. Though the semi-military 
character of the early nursing school 



APRIU 1959 • VOL. 55. No. 4 



303 



days has been considerably diminished, 
a degree of discipHne is essential. In 
order to produce the highest level of 
service this discipline must be intelli- 
gently enforced and accepted. An ap- 
preciation of the need for and value 
of this discipline should be an inte- 
gral part of every young graduate's 
professional equipment. School days 
may be over but there must be no re- 
laxation in her adherence to the discip- 
line that has become a part of her life. 
In addition to discipline, nursing 
philosophy recognizes the need for 
initiative, the ability to think through 
problems, poise, emotional maturity, 
and a ready adaptability to change. 
These qualities do not suddenly blos- 
som at graduation. They have been 
cultivated carefully, day by day, all 
through the undergraduate period. 



They are the result of practical ex- 
perience in every branch of nursing 
available in the hospital. Coupled with 
a sound sense of service they make 
possible the maintenance of the high 
standards that are the hallmark of 
Canadian nursing. 

"Service" means many different 
things to different people. The at- 
titude of the general public toward 
nursing is molded to a considerable 
extent by the individual nurses that 
the men and women, who make up the 
public, know personally. So, on every 
new graduate is laid the responsibility 
of developing good public relations 
wherever she goes by serving with 
efficiency, integrity and, above all, with 
dignity as she goes about her daily 
tasks. 



Two Letters of Interest 



FAR TOO LONG HAS GONE BY before I scem 
to have had an opportunity to write and 
tell you the way in which the most generous 
gift from the Canadian Nurses' Association 
has been expended. 

I now want you to know that we have 
made two purchases with the money. A very 
attractive carpet has been laid in the office 
of the Nursing Service Division, and we 
have also acquired an antique silver tea-pot. 
Before we had your gift it had been decided 
that the office of the Nursing Service 
Division (otherwise Miss Beck's office) 
should have rugs but should not be close 
carpeted. The advantage of a carpet over 
rugs hardly needs to be stressed, and due 
to your gift, the office is now greatly im- 
proved both in appearance and comfort. 

When I was with you and you mentioned 
the possibility of expending the donation 
on a tea-set, I explained that the South 
African Nursing Association had already 
given us a donation with which a Wedge- 
wood tea-set had been purchased, but we 
did need a more elegant tea-pot ; and the 
antique silver one which we have now pur- 
chased certainly adds dignity to the set and 
is used on many occasions when we entertain 
visitors at this Headquarters. 

I hope you will express once again to 
your Executive Committee when the oppor- 
tunity arises our deep appreciation of your 



gift and the thoughtfulness which promoted 
it, and we are so happy to have this evi- 
dence of your confidence and afifection with- 
in our Headquarters. 

With greetings and good wishes to all of 
you, 

Yours sincerely, 

Daisy C. Bridges, 
General Secretary. 
* * * 

I am aware that at this meeting a build- 
ing fund was established so that the Cana- 
dian Nurses' Association might in the future 
have suitable headquarters, to be known as 
C.N. A. House. It seems fitting that the 
founder of the Association should have some 
part in realizing the dream of the Associ- 
ation and I would ask that the honorarium 
for the Mary Agnes Snively Memorial 
Address for 1958 be credited to this fund. 

Please be assured that the Association 
would give me pleasure by permitting me to 
play this small part in the future of the 
Canadian Nurses' Association. 
Sincerely yours, 

W. S. Stanbury, M.D., 
National Commissioner. 



High slim heels are not suitable for 
women who drive a car. This type of heel 
can easily slip off brake or accelerator. 

— Dept. of National Health and Welfare 



304 



THE CANADIAN NURSE 



Cardiac Arrest 



Lionel F. G. Cruickshank, M.B. CnB., (Edinburgh). D.A. (Eng.), 
F.F.A.R.C.S.E. 



WHEN THE DREADFUL WORDS "cardiaC 
arrest" are mentioned during the 
coffee break, are you one of the nurses 
who prays that it will not occur during 
your next case, who flies into a panic, 
or hopes that somebody else will know 
the answers? 

What are the facts? Most centres 
agree that the incidence is from 1 in 
2,000 to 1 in 5,000 cases. It is more 
common under the age of ten years, 
approximately 20% ; more in men than 
in women. About 13 per cent occur 
outside the operating room in various 
other departments. 

The causes are many but the main 
ones are : 

1. Anoxia and/or carbon dioxide ex- 
cess. 

2. Reflexes which affect the heart. 

3. Anesthetic agents, e.g.. chloroform 
and trilene. 

4. Hypotension. 

5. Cases with electrolyte imbalance. 
For how many operations did you 

say that you were the scrub nurse? 
How often did you see one of the above 
causes present in these cases ? None ! 
Well, your next case may be the big 
one. How are you going to rate so far 
as your medical ability is concerned? 
Are there any warning signs that 
might raise suspicion that things are 
going wrong? Watch out for the 
following signals : 

1. Change in rate or type of respi- 
ration. 

2. Persistent cyanosis. 

3. Very slow or rapid heart rate. 

4. An unexplained drop in blood 
pressure. 

5. A worried anesthetist. 

In any drill there must be a constant 
component and time is the factor for 
the beginning, duration and end of a 
cardiac arrest drill. If the brain can 
receive oxygenated blood within three 
or four minutes of the arrest then 
about 90 per cent of cases should 

Dr. Cruickshank is one of the senior 
anesthetists at the Winnipeg General 
Hospital. 



be successfully resuscitated. After four 
minutes, the figure drops to about 6 
per cent successful with the word 
"vegetable" being applicable to some 
of the remainder. 

Every act of every person is related 
to time. The time is a sequence of 
three minutes, which after all are only 
180 seconds, and there are very few 
to spare. The drill can be compared 
to a square dance. People come to the 
dance, take various steps and leave 
again but the time or tempo is controll- 
ed by a caller and so the dance is kept 
in rhythm. If there is no caller then 
the dance will fail and so will the 
cardiac arrest drill because nobody will 
know what the other people are doing 
and the whole performance looks like 
a disturbed crowd of ants. 

Let us imagine that a patient is in 
an operating room with plenty of staff 
and all necessary equipment. Suppos- 
ing the anesthetist announces cardiac 
arrest. 

During the first minute: 

The surgeon 

Stops operating. 

Checks for pulse or heart beat if 
working inside the abdomen or chest. 

Does nothing otherwise. 

The anesthetist 

Stops the anesthetic. 

Places patient in Trendelenberg po- 
sition at 5-10 degree tilt. 

Gives oxygen at 10 litres a minute 
with controlled respiration. 

The interne 

Checks with stethoscope for heart 
beat and leaves the chest bare. 

Arranges the intravenous with pres- 
sure apparatus attached. 

The scrub nurse 

Looks to see that the following are 
present : antiseptic paint, knife and 
cardiac arrest set. 

The waiting nurse 

Calls the time at 30 second intervals. 

Helps the interne with the I.V. 

During the second minute: 

The surgeon 
Picks up the knife. 



APRIL. 1959 • VOL, 55. No. 4 



305 



Asks the scrub nurse to open cardiac 
arrest set. 

The anesthetist 

Continues as before and intubates if 
necessary. 

The interne 

Re-scrubs. 

The scrub nurse 

Paints the chest. 

Opens cardiac arrest set. 

The waiting nurse 

Calls the time. 

Gives the scrub nurse the cardiac 
arrest set. 
During the third minute: 

The surgeon 

Nicks the chest to see if there is any 
bleeding. 

Incises the fourth left intercostal 
space and begins cardiac massage. 

The anesthetist 

.Advises the surgeon regarding drugs. 

The interne 

Helps the surgeon. 

The scrub nurse 

Fills the syringes with required drugs. 

The waiting nurse 

Calls the time. 
The surgeon will massage the heart 
with a milking motion, at the rate of 
60 times a minute. He will probably 
open the pericardium. If the massage 
is being properly carried out, a palpa- 
ble radial pulse and a systemic blood 
pressure of about 60 mm. Hg. should 
be present. The surgeon, after a period 
of massage, will announce that the 
heart is in arrest or fibrillation. The 
treatment differs for each and different 
drugs are required. The cardiac arrest 
set must contain all of them. 

For arrest the drugs required are : 

y2 cc. ampoules of adrenaline 1 :1000 

10 cc. ampoules of novocaine 1% 

ampoules of atropine 1/75 gr. 

10 cc. ampoules of calcium chloride 
10% 
Fibrillation requires : 

10 cc. novocaine ampoules 1% 

Potassium chloride ampoules 40 mg. 



A defibrillator that will give a voltage 
of up to 200, carries an amperage of 
1.5 to 2.5 and allows the shock to be 
given for at least up to a total of 1 
second. 

These drugs are injected into the 
ventricles of the heart by the surgeon. 
He will ask for the one he requires 
and its strength. He will also control 
the voltage and time of the defibrillator. 
The nurse does not need to concern 
herself with the action of the drugs, 
only that they are present in the 
cardiac arrest set. 

The set .should also contain a knife, 
a few hemostats, a pair of scissors and 
syringes with needles and ampoules of 
normal saline. 

If the cardiac arrest occurs and only 
a nurse is present, she should start 
artificial respiration and keep track of 
the time. When help arrives, people 
will know what treatment to begin 
according to the time sequence of the 
drill. 

Once the heart has started again, the 
following must be established for the 
after-care of the patient : 

An artificial respirator or ventilator 
Water-seal drainage for the chest 
Clear airway and tracheotomy, if 
necessary 

Fluid balance because of cerebral 
edema 

Feeding — gastric and I.V. 
Antibiotics 

Hypothermia because of central anoxia 
E.K.G. tracings 
Blood pressure apparatus 
Cardiac glucosides 
In conclusion, the main factor is 
time. To be able to use the time 
properly, practice is required. All 
personnel should know the duties of 
each member of a cardiac arrest team 
so that all can be interchangeable. 
Everv month a cardiac arrest practice 
should be carried out so that there is 
no need for fear or panic but in order 
to assure a steady, always ready team. 



To be adult it is necessary to possess : 
The wisdom to be dissatisfied with the way 
things are ; the boldness to attempt to change 
them; and the patience to do it in the com- 
pany of others who disagree as to how it 
should be done. — Dr. Kenxeth D. Benne 



Nursing is not a thing of provinces, it 
is not even a thing of nations ; it is as 
broad as civilization and as deep as human 
need. 

— Ethei. Johxs, The Canadian Nurse, 
Tune. 1916. 



306 



THE CANADIAN NUR?E 



Congenital Heart Surgery 



A. T. MiLDF.XBERC.ER 

I RECENT STATISTICAL REPORT Oil 

il 30,036 unselected autopsies in Min- 
nesota indicated that one to two per 
cent of these persons had been born 
with a heart defect. Further statistics 
from a Colorado survey in 1952 indi- 
cated that roughly 25',000 to 50,000 
infants are born in the United States 
yearly with congenital heart defects. 
If we assume that the same ratio 
applies to Canadian births, then one 
or two infants out of every 100 births 
in Canada is affected with a heart 
malformation. 

The cause of the incomplete or im- 
proper development of the heart is not 
known. In some cases it has been at- 
tributed to German measles or some 
other systemic infection of the mother 
during pregnancy. In many infants 
there are early signs of heart defect. In 
others the condition may exist for 
months or years without becoming ap- 
parent. Although incidence is relative- 
ly beyond control, corrective surgery is 
becoming more and more successful. 
Types of congenital heart disease vary 
considerably but basically the nursing 
care is the same for surgery of all types. 

Early History 

In the case of little Jean Howard, 
heart murmurs had been detected 
since birth, but no other symptoms 
warned the parents of impending 
danger. Alert and active despite a 
tiny, slow-growing body, Jeannie did 
not tire noticeably, did not have faint- 
ing spells, and was not subject to 
undue respiratory infections. However, 
when the child was two years old she 
was hospitalized with pneumonia. An 
x-ray revealed an enlarged heart. 

After recovery from the pneumonia 
a heart catheterization was perform- 
ed. The catheter did not pass through 
any defects, but the blood samples 
drawn from the right auricle were 
highly oxygenated and indicated a left- 
to-right shunt. Cardiac catheterization 

Miss Mildenberger is a graduate of St. 
Elizabeth's Hospital. Humboldt, Sask. 

.■\PRII.. 1959 • VOL. 55. No. 4 



and other tests, although narrowing 
the cause of heart distress to several 
types of defect, do not determine the 
exact anomaly nor the extent of the 
malformation. 

Surgery was considered necessary 
for Jean. She was referred to Uni- 
versity of Minnesota Hospitals where 
the extra-corporeal circulation method 
had been successfully practised in sur- 
gical correction of numerous cardiac 
defects since March 1954. Jean was 
sent home to await further plans. She 
had been placed on digitalis "'to prevent 
heart failure." 

In the interim between March and 
July. Jeannie's parents concentrated 
on expenses for the operation. The 
Howards, who had lost their other 
child shortly after its birth, were de- 
termined to overcome all obstacles. 

In July, Jeannie again entered her 
local hospital, this time for a physical 
check-up and a repeat catheterization 
of the heart. Now a "very marked pre- 
cordial bulge" was present. Her chest 
was considered out of proportion to 
the rest of her body. Although well- 
nourished, her weight was low at 21^ 
pounds. On this occasion, the catheter- 
izing tube passed through the atrial 
defect from the right upper chamber 
to the left upper chamber. Moderate 
pulmonary hypertension was noted. It 
was estimated that 5/6ths of the blood 
volume was passing through the inter- 
atrial defect to be recirculated through 
the lungs rather than circulated through 
the body. Though surgery was con- 
sidered a great risk, much more delay 
of the operation might be too late. The 
plans proceeded for immediate surgery. 

About six to eight donors, group 
A Rh positive blood, were to be found 
by the parents. The donors had to be 
available within 24 hours prior to the 
scheduled surgery. Red Cross blood, 
which is preserved using citrates as 
an anticoagulant, was not suitable for 
this type of surgery. 

Surgical Treatment 

Tmmediatelv prior to surgery Jean- 

307 



nie's weight had increased to 23 
pounds. Throughout a week of obser- 
vation her pulse ranged from 100-126, 
respirations from 20-48, and tempera- 
ture from 99-100-. Daily fluid intake 
averaged 700 cc. Up and about during 
this period, the child was alternately 
happy and irritable. She liked company 
and showed great curiosity. She enjoy- 
ed helping the nurses whenever pos- 
sible. 

Preoperative orders included con- 
tinuation of digitoxin and daily in- 
jections of Vidaylin and Vipenta that 
were given intramuscularly. Numer- 
ous blood tests, as well as a routine 
urinalysis and a chest plate were re- 
quested. A week after admission sur- 
gery was performed. 

Nothing per ora was given after 
4:00 A.M. on the morning of operation. 
Preoperative sedation, given hypoder- 
mically at 9:30 a.m., consisted of 
Seconal gr. J/^ and atropine gr. 1/400. 
Sodium pentothal anesthesia was used 
initially, and oxygen was administered 
continually by mask. A cut- down of 
the saphenous vein was done, then a 
transverse, sternal chest incision was 
made. After the chest opening was 
complete, cannulae were inserted into 
the venae cavae and aorta. They were 
connected to the oxygenator machine. 
When the circulation bypass was under- 
way, and the heart was "dry," an 
incision was made into the heart ex- 
posing an ostium primum interatrial 
septal defect and a cleft mitral valve. 
An interatrial defect is not the same 
thing as a patent foramen ovale. Al- 
though the foramen ovale frequently 
does not close after birth the valve on 
the left side prevents the blood from 
flowing left to right. Since pressure 
is greater on the left side the blood 
cannot flow through the patency from 
right to left. In the case of persistent 
ostium primum, this primary growth of 
the septum had been arrested in the 
fetus leaving a gap between it and the 
septum secundum. Thus, as much as 
90 per cent of the blood volume is shunt- 
ed from the left to the right atrium 
because of the difference in pressure. 
The cleft in the mitral valve was 
sutured, followed by repair of the 
interatrial defect with an Ivalon sponge 
patch. Body circulation was restored 
through the heart, two chest tubes 
were inserted for drainage, and the 



chest incision was closed. The oxy- 
genator was used for thirty-one 
minutes. 

Postoperative Care 

Three hours after the beginning of 
surgery, the child now semiconscious, 
was moved to the postanesthesia 
room. She was placed in a croupette 
and oxygen was administered at three 
litres per minute. To help loosen the 
thick mucus in her throat, Alevaire 
was given by nebulizer for 10 minutes 
each hour. Vital signs were checked 
q.l5 minutes, temperature q.^ hour, 
unless elevated. 

She was transferred from the post- 
anesthesia room to the Heart Hospital 
on the second day, and kept in an 
oxygen tent continuously until the 
third day. Then the gradual weaning 
began with as much as two-hour 
periods out of the tent at a time. 

Blood transfusion was continued at 
the rate of blood loss as measured 
every half hour from the drainage 
bottles. (The blood loss during sur- 
gery, 600 cc. had been replaced in 
the operating room.) To aid chest 
drainage, a mechanical "stripper" was 
used to milk the tubes. Penicillin, 
200,000 units was ordered every six 
hours. Streptomycin .125 gm. every 
12 hours. Intravenous fluids to the 
amount of 250 cc. were to be given in 
24 hours. 

When the first private nurse came 
on duty at 3:00 p.m., Jeannie was al- 
ready quite alert and moving about 
restlessly. Her hands had been tied to 
the bed railings to keep her from 
pulling out the tubes. She had also 
started to cross her legs with her knees 
drawn up — a peculiar characteristic 
of children with heart defects. Al- 
though irritable Jeannie responded 
well to the frequent questions of 
doctors, interns and nurse. 

The child's color was good until 
around 4:00 p.m., when she began 
to show circumoral cyanosis. This was 
gradually relieved after a large amount 
of thick mucus was suctioned from 
her nose, and a stomach tube had been 
passed, aspirating 70 cc. of air and 5 
cc. of gastric secretion. Her pulse was 
140, blood pressure 140, and tempera- 
ture lOP. Ice bags were used to bring 
the temperature down to 99. 



306 



THE CANADIAN NURSE 



Blood loss through the drains 
amounted to 100 cc. between 2:00 p.m. 
and 4:00 p.m., gradually lessening so 
that both tubes were removed on the 
second postoperative day. 

A chest plate, taken about two hours 
after surgery, revealed some pleural 
reaction and aspiration pneumonitis at 
the right base. The chest tubes were 
draining well and there was no evi- 
dence of gross pneumothorax, consoli- 
dation or effusion. Repeated six hours 
later, the x-ray showed the right lower 
lobe infiltration to be cleared. Moderate 
gaseous distention of the stomach was 
noted. A stomach tube was again 
passed and 60 cc. of air removed. 

Since it was prone to a sudden drop 
in rate, the apical pulse was taken 
q.l5 minutes for several days until 
fairly stable, then it was taken every 
half hour of the day. Isuprel (isopropyl- 
arterenol N.N.R.) 5 mg., was given 
whenever the pulse dropped to 100. 
Administered rectally, it was first given 
at 9:00 p.m. on the day of surgery, and 
on the second day was ordered q. 2 h. 
to combat the effects of heart block. 
The pulse fluctuated from 104-124 on 
the first evening, and from 122-142 
the next day. 

Isuprel has the action of epinephrine 

in stimulating the sympathetic nervous 

system, and increasing the heart rhythm 

and blood pressure. It also possesses 

the anti-allergic actions of epinephrine. 

On the second day after surgery, 
only two doses of Isuprel were requir- 
ed, but on the third day the pulse 
dropped low four times. An attempt 
was made on the fifth day to cut the 
dosage in half, but this did not prove 
satisfactory. The cardiac stimulant 
was not required after the seventh day 
since the heart block was finallv reliev- 
ed. 

The pulse quality remained good 
throughout, with regularity of rhythm. 
Elevation of pulse and respirations 
appeared to coincide with the crying 
spells that generally accompanied the 
administration of injections or other 
d